title: Time-based trauma-related mortality patterns in a newly created trauma system.
abstract: BACKGROUND
  Data on time-based trauma mortality (TTM) patterns in developing countries are lacking.
  
  
  OBJECTIVE
  Our objective was to analyze the TTM in a newly established trauma center.
  
  
  METHODS
  A retrospective analysis of all trauma-related mortality between 2010 and 2012 was conducted in Qatar. Based on the time of injury, deceased cases were categorized into immediate (pre-hospital), early (first 24 h), and late (>24 h) groups. TTM was analyzed and compared.
  
  
  RESULTS
  A total of 4,966 trauma patients were admitted to the trauma center over 3 years; of them, 333 trauma-related deaths (6.8 %) were documented and reviewed. The death pattern peaked immediately post-trauma (n = 142), followed by 96 deaths within the first 24 h, 19 deaths within the time period >24 to 48 h, 50 deaths within the 3rd and 7th day (second peak), and 26 deaths after the 1st week. The majority of the deceased were males, with a mean age of 36 ± 17 years. Motor vehicle crashes (43.5 %) were the commonest mechanism of injury. At presentation, median injury severity score (ISS) was 32 (range 9-75). Bleeding, abdominal, and pelvic injuries were higher in the early group, whereas head injuries were observed more in the late mortality group. Co-morbidities and in-hospital complications were predominantly encountered in the late group. Head injury (odds ratio [OR] 3.760; 95 % confidence interval [CI] 1.311-10.797) was an independent predictor for late death, whereas the need for blood transfusion was a predictor for early death (OR 3.233; 95 % CI 1.125-9.345).
  
  
  CONCLUSIONS
  The distribution of mortality shows a bimodal pattern. The high rate of death at the scene highlights the importance of pre-hospital care and the need for injury prevention programs.
authors.affiliation: Section of Trauma Surgery, Department of Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Husham
authors.initials: H
authors.lastname: Abdelrahman
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Thani
authors.forename: Rafael
authors.initials: R
authors.lastname: Consunji
authors.forename: Ahmad
authors.initials: A
authors.lastname: Zarour
authors.forename: Ruben
authors.initials: R
authors.lastname: Peralta
authors.forename: Ashok
authors.initials: A
authors.lastname: Parchani
authors.forename: Rifat
authors.initials: R
authors.lastname: Latifi
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011780:Qatar / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000401:mortality*
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