ArticlePloS one2019
Changes in the temporal distribution of in-hospital mortality in severely injured patients-An analysis of the TraumaRegister DGU.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Are Pre-hospital Trauma Deaths Preventable? A Systematic Literature Review.World journal of surgery · 2019Pooled it
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- Incidence and predictors of early mortality among trauma patients visiting emergency departments of referral hospitals in west Amhara region, Ethiopia.Scientific reports · 2026Observational
- On-scene predictors of injury severity, deterioration, and death following road injury: a systematic scoping review of information available to responders and its use in triage tools.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): in action or on the shelf? A comprehensive analysis of current practices in Germany, Austria, and Switzerland - insights from the Traumaregister DGUBMC emergency medicine · 2025Article
- Clinical patterns and predictors of trauma-related mortality over 13 years: a retrospective analysis from a Level 1 National trauma center.World journal of emergency surgery : WJES · 2025Article
- Bimodal, But Not the Same: Persistent Late Peaks in Trauma Mortality.World journal of surgery · 2025Article
- Daily Improvement in APACHE II Score (APACHE/m) and Outcomes in ICU Trauma Patients.Risk management and healthcare policy · 2025Article
- Prehospital Trauma Scoring Systems for Evaluation of Trauma Severity and Prediction of Outcomes.Medicina (Kaunas, Lithuania) · 2023Observational
- Trauma deaths of hospitalized patients in Abu Dhabi Emirate: a retrospective descriptive study.World journal of emergency surgery : WJES · 2023Article
- The Need for Trauma Management Training and Evaluation on a Prehospital Setting.International journal of environmental research and public health · 2022Article
- The significance of a concomitant clavicle fracture in flail chest patients: incidence, concomitant injuries, and outcome of 12,348 polytraumata from the TraumaRegister DGUEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Nine year in-hospital mortality trends in a high-flow level one trauma center in Italy.Updates in surgery · 2022Article
- Role of electrocardiogram findings in predicting 48-h mortality in patients with traumatic brain injury.BMC neurology · 2022Observational
- Immune dysfunction following severe trauma: A systems failure from the central nervous system to mitochondria.Frontiers in medicine · 2022Review
- Article
- [Medical drones: innovative therapeutic strategies].Der Unfallchirurg · 2021Article
- [Measurability of the quality of care of the severely injured].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021Review
- Design and Development of an Interactive Web-Based Simulator for Trauma Training: A Pilot Study.Journal of medical systems · 2021Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe temporal distribution of trauma mortality has been classically described as a trimodal pattern with an immediate, early and late peak. In modern health care systems this time distribution has changed.
methodsData from the TraumaRegister DGU was analysed retrospectively. Between 2002 and 2015, all registered in-hospital deaths with an Injury Severity Score (ISS) ≥ 16 were evaluated considering time of death, trauma mechanism, injured body area, age distribution, rates of sepsis and multiple organ failure. Pre-hospital and post-discharge trauma deaths were not considered.
results78 310 severely injured patients were registered, non-survivors constituted 14 816, representing an in-hospital mortality rate of 18.9%. Mean ISS of non-survivors was 36.0±16.0, 66.7% were male, mean age was 59.5±23.5. Within the first hour after admission to hospital, 10.8% of deaths occurred, after 6 hours the percentage increased to 25.5%, after 12 hours 40.0%, after 24 hours 53.2% and within the first 48 hours 61.9%. Mortality showed a constant temporal decrease. Severe head injury (defined by Abbreviated Injury Scale, AIS-Head≥3) was found in 76.4% of non-survivors. Patients with an isolated head injury showed a more distinct decrease in survival rate, which was accentuated in the first days after admission. The correlation of age and time of death showed a proportional increase with age (55-74a). The rate of sepsis and multiple organ failure among non-survivors was 11.5% and 70.1%, respectively.
conclusionIn a modern trauma care system, the mortality distribution of severely injured patients has changed its pattern, where especially the third peak is no longer detectable.
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