Autopsy findings from 111 deaths in the 1999 Athens earthquake as a basis for auditing the emergency response

Br J Surg. 2004 Dec;91(12):1633-40. doi: 10.1002/bjs.4752.


Background: The aim of the study was to assess the emergency response to an earthquake.

Methods: This retrospective study, based on formal autopsy findings from 111 earthquake-related deaths, evaluated demographic data, circumstances of death, rescue time, mechanisms of injury, causes of death, Abbreviated Injury Scale (AIS 90) and Injury Severity Score (ISS) values, vital functions, co-morbidity and preventable deaths.

Results: The median extrication time for 99 of 102 victims buried or trapped in collapsed buildings was 2.1 (range 0.1-7.8) days. Deaths were cause by blunt injuries, asphyxia and myocardial infarction. Injuries impaired the airway, breathing, circulation, and brain or spinal functions in 10.5, 61.9, 46.6 and 57.1 per cent of the victims respectively. The 105 injured victims were classified into three main categories. The first comprised 36 victims (34.3 per cent) with injuries not compatible with life (ISS 75), the second included 38 victims (36.2 per cent) who suffered life-threatening injuries (ISS 9-74) but had no evidence of asphyxia, and the third category contained 31 victims (29.5 per cent) with findings of asphyxia and an ISS of 1-18. The reviewers concluded that 13 trauma-related deaths and 31 deaths from asphyxia were potentially preventable.

Conclusion: A method based on detailed evaluation of deaths provided information with which to audit the emergency response to an earthquake.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Autopsy
  • Child
  • Child, Preschool
  • Disaster Planning
  • Disasters*
  • Emergencies
  • Emergency Medical Services / standards*
  • Greece / epidemiology
  • Humans
  • Infant
  • Injury Severity Score
  • Medical Audit
  • Middle Aged
  • Retrospective Studies
  • Time Factors
  • Wounds and Injuries / mortality*