title: [Structure of hospital lethality in polytrauma and ways to reduce it].
abstract: Case histories of 276 patients and autopsy protocols for patients who had died of polytrauma in 2002-2003 were analyzed. It was found that hospital polytrauma lethality is characterized by two peaks: within the first 24 hours after trauma (34.3% of the victims) and on day 4 and later after polytrauma (53.2%). Acute blood loss and shock are the cause of early lethality. In the period from 1 to 3 days after trauma the main causes of death are edema and dislocation of the brain in patients with dominating craniocerebral injury. Late mortality (on day 4 and later) is associated with infectious complications. The overall lethality after polytrauma decreased from 26-30% to 18.5-18.9% for the recent 10 years due to shortening of presurgical period, "cell-saver" use, improvement of anesthetic and intensive care management, mini-invasive osteosynthesis, timely prevention and treatment of brain edema, preventive use of last generation antibiotics and immune correction.
authors.forename: A S
authors.initials: AS
authors.lastname: Ermolov
authors.forename: M M
authors.initials: MM
authors.lastname: Abakumov
authors.forename: V A
authors.initials: VA
authors.lastname: Sokolov
authors.forename: V I
authors.initials: VI
authors.lastname: Kartavenko
authors.forename: I E
authors.initials: IE
authors.lastname: Galankina
authors.forename: D A
authors.initials: DA
authors.lastname: Garaev
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality* / Q000534:rehabilitation*; D011314:Preventive Health Services / Q000458:organization & administration*; D012426:Russia / Q000453:epidemiology