Preventability of pre-hospital trauma deaths in southern New Zealand

Abstract

Aim: To assess the preventability of pre-hospital trauma deaths in the Otago and Southland regions of New Zealand.

Methods: A retrospective audit was carried out of all post-mortems from trauma deaths that occurred in these regions between January 2000 and December 2004. The injuries documented in the post-mortem reports were scored using the Abbreviated Injury Scale (AIS) 2005 and from this an Injury Severity Score (ISS) derived. Based on the ISS groupings of Sampalis et al, a probability of the preventability of death was then determined.

Results: A total of 362 deaths were identified. Post-mortems were available for 245; 54 were excluded and 191 had their post-mortems scored according to the AIS 2005 with derivation of an ISS. Of these, 19 (10%) were classified as having survivable injuries, 66 (35%) potentially survivable injuries and 106 (55%) non-survivable injuries. The majority were aged 35 years or younger (51%), male (71%) and suffered significant injuries to multiple regions (76% to two regions, 51% three or more regions) and were the result of a motor vehicle accident (70%).

Conclusions: In trauma-related deaths in southern New Zealand, the majority of patients who die before reaching hospital do so from non-survivable injuries; however, a significant proportion has either potentially survivable or survivable injuries. These results are very similar to comparable international studies and suggest that there should be further attempts at improving pre-hospital care while also aiming to improve primary prevention. Further research is required.