title: Preventable and potentially preventable deaths in severely injured patients: a retrospective analysis including patterns of errors.
abstract: OBJECTIVE
  Analyzing preventable and potentially preventable deaths is a well-known procedure for improving trauma care. This study analyzes preventable and potentially preventable deaths in German trauma patients.
  
  
  METHODS
  Patients aged between 16 and 75 years with an Injury Severity Score >15 who were primary admitted from July 2002 to December 2011 were analyzed in this study. Data from the patients' hospital records were retrospectively analyzed, and cases were categorized as preventable, potentially preventable, and non-preventable deaths. In addition, trauma management was screened for errors.
  
  
  RESULTS
  2304 patients were admitted from July 2002 to December 2011. 763 of which fulfilled the defined criteria. The mortality rate was 25.3 %. Eight cases (4.2 %) were declared as preventable deaths and 31 cases (16.1 %) as potentially preventable deaths. The most common errors in preclinical trauma care related to airway management. The main clinical error was insufficient hemorrhage control. Fluid overload from infusion was the second most common fault in both.
  
  
  CONCLUSIONS
  Preventable and potentially preventable errors still occur in the treatment of severely injured patients. Errors in hemorrhage control and airway management are the most common human treatment errors. The knowledge of these errors could help to improve trauma care in the future.
authors.affiliation: Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany. carsten.schoeneberg@krupp-krankenhaus.de.
authors.forename: C
authors.initials: C
authors.lastname: Schoeneberg
authors.affiliation: Clinic for Orthopedics, Pius-Hospital Oldenburg, Oldenburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schilling
authors.affiliation: Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hussmann
authors.affiliation: Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Schmitz
authors.affiliation: Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Lendemans
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Marburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Ruchholtz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058109:Airway Management / Q000401:mortality / Q000592:standards; D019985:Benchmarking; D002423:Cause of Death; D005260:Female; D005858:Germany / Q000453:epidemiology; D006470:Hemorrhage / Q000401:mortality / Q000517:prevention & control; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality; D012042:Registries; D012189:Retrospective Studies; D014193:Trauma Centers / Q000592:standards*; D014947:Wounds and Injuries / Q000401:mortality*; D055815:Young Adult
keywords: Adults; Errors; Mortality; Severely injured; Trauma