Is the trimodal pattern of death after trauma a dated concept in the 21st century? Trauma deaths in Auckland 2004

Injury. 2008 Jan;39(1):102-6. doi: 10.1016/j.injury.2007.05.022. Epub 2007 Sep 18.

Abstract

Objective: To determine whether the classical trimodal distribution of trauma deaths is still applicable in a contemporary urban New Zealand trauma system.

Methods: All trauma deaths in the greater Auckland region between 1 January 2004 and 31 December 2004 were identified and reviewed. Data was obtained from hospital trauma registries, coroner autopsy reports and police reports.

Results: There were 186 trauma deaths. The median age was 28.5 years and the median Injury Severity Score was 25. The predominant mechanisms of injury were hanging (36%), motor vehicle crashes (31.7%), falls (9.7%), pedestrian-vehicle injury (5.4%), stabbing (4.3%), motorcycle crashes (3.2%), and pedestrian-train injury (2.2%). Most deaths were from central nervous system injury (71.5%), haemorrhage (15.6%), and airway/ventilation compromise (3.8%). Multi-organ failure accounted for 1.6% of deaths. Most deaths occurred in the pre-hospital setting (80.6%) with a gradual decrease thereafter.

Conclusion: There was a skew towards early deaths. The trimodal distribution of trauma deaths was not demonstrated in this group of patients.

MeSH terms

  • Accidents, Traffic / mortality*
  • Accidents, Traffic / prevention & control
  • Adolescent
  • Adult
  • Aged
  • Cause of Death
  • Child
  • Child, Preschool
  • Epidemiologic Methods
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • New Zealand / epidemiology
  • Sex Distribution
  • Suicide Prevention
  • Trauma, Nervous System / mortality*
  • Trauma, Nervous System / prevention & control
  • Wounds, Nonpenetrating / mortality*
  • Wounds, Nonpenetrating / prevention & control