Analysis of preventable trauma deaths and inappropriate trauma care in a rural state.
The goal of this study was to determine the rate of preventable mortality and inappropriate care in cases of traumatic death occurring in a rural state.
This is a retrospective case review.
Materials and Methods
Deaths attributed to mechanical trauma throughout the state and occurring between October 1,1990 and September 30,1991 were examined.
All cases meeting inclusion criteria were reviewed by a multidisciplinary panel of physicians and nonphysicians representing the prehospital as well as hospital phases of care.
Deaths were judged frankly preventable, possibly preventable, or nonpreventable.
The care rendered in both preventable and nonpreventable cases was evaluated for appropriateness according to nationally accepted guidelines.
Measurements and Main Results
The overall preventable death rate was 13%. Among those patients treated at a hospital, the preventable death rate was 27%. The rate of inappropriate care was 33% overall and 60% in-hospital.
The majority of inappropriate care occurred in the emergency department phase and was rendered by one or more members of the resuscitation team, including primary contact physicians and surgeons.
Deficiencies were predominantly related to the management of the airway and chest injuries.
The rural preventable death rate from trauma is not dissimilar to that found in urban areas before the implementation of a trauma care system.
Inappropriate care rendered in the emergen...
Mots-clés Pascal : Traumatisme, Epidémiologie, Homme, Mortalité, Milieu rural, Système santé, Evaluation, Montana, Pertinence, Soin, Mort évitable, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Trauma, Epidemiology, Human, Mortality, Rural environment, Health system, Evaluation, Montana, Relevance, Care, Preventable death, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0069468
Code Inist : 002B30A01A2. Création : 199608.