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Independent factors of preventable death in a mature trauma center: a propensity-score analysis

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

The rate of potentially preventable deaths (PPD) and preventable deaths (PD) can reach more than 20% of overall trauma mortality. Bleeding is the leading cause of preventable mortality. The aim of our study is to define the independent factors of preventable or potentially preventable mortality in our mature trauma system.

Materials and methods

We conducted a single-center retrospective study in the Sainte Anne Military Teaching Hospital, Toulon, France, including all severe trauma patients admitted to our trauma center and discharged alive as well as all severe trauma patients who died with a death considered preventable or potentially preventable from January 2013 to December 2020. We matched the two groups using a propensity score and searched for independent factors using a generalized linear model.

Results

846 patients were included and analyzed. After matching, our cohort consisted of 245 patients in the survivor group and 49 patients in the preventable deaths group. Pre-hospital delays (73 min vs 54 min P = 0.003) as well as delays before incision in the operating room (80 min vs 52 min P < 0.001) were significantly longer in the PD group. These delays were independent factors of preventable mortality OR 10.35 (95% CI [3.44–31.11] P < 0.001) and OR 37.53 (95% CI [8.51–165.46] P < 0.001) as well as pelvic trauma OR 6.20 (95% CI [1.53–25.20] P = 0.011).

Conclusion

Delays in pre-hospital care, delays in access to the operating room from arrival at the trauma center, and pelvic injuries are independent factors associated with an increased risk of preventable mortality in trauma.

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Funding

This study did not receive any financial assistance.

Author information

Authors and Affiliations

  1. Anaesthesiology and Intensive Care Department, Military Teaching Hospital Sainte Anne, Toulon, France

    Marion Robaix, Quentin Mathais, Hilaire de Malleray, Sarah Guigues, Eric Meaudre, Julien Bordes & Michael Cardinale

  2. Ecole du Val de Grâce, French Military Medical Academy, Paris, France

    Eric Meaudre & Julien Bordes

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  1. Marion Robaix
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  2. Quentin Mathais
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  3. Hilaire de Malleray
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  4. Sarah Guigues
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  7. Michael Cardinale
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Contributions

MC, JB, and MR design the study. MC is its guarantor. MR, SG, and HM managed the data collections. MC, QM, and HM established and managed the statistical analysis. All the authors have contributed to write the manuscript and approved the final manuscript.

Corresponding author

Correspondence to Michael Cardinale.

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The authors declare that they have no competing interests. The publication has not been published elsewhere.

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Robaix, M., Mathais, Q., de Malleray, H. et al. Independent factors of preventable death in a mature trauma center: a propensity-score analysis. Eur J Trauma Emerg Surg 50, 477–487 (2024). https://doi.org/10.1007/s00068-023-02367-w

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  • DOI: https://doi.org/10.1007/s00068-023-02367-w

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