Incidence and etiology of mortality in polytrauma patients: an analysis of material from Multitrauma Centre of the University Teaching Hospital no 1 in Szczecin, over a period of 3 years (2017–2019)

Introduction: The pattern of traumatic death is a subject of great interest in the worldwide literature. Most studies have aimed to improve trauma care and raise awareness of avoidable fatal complications. Aim: The objective of the present study was an epidemiological and clinical analysis of causes of traumatic death of patients treated at the Multitrauma Centre of the University Teaching Hospital No 1 in Szczecin, over a period of 3 years (2017–2019). Material and methods: The study material comprised medical data of 32 patients with a mean age of 63 years, who died due to polytrauma injury. The time of death form admission to the Multitrauma Centre, primary cause of death, spectrum and sites of injuries, as well as method of treatment (operative or conservative) were variables considered in the analysis. Results: The predominant mechanisms of injury were traffic accidents – 22 cases (69%) followed by falls from a height 8 (25%) and other mechanism – 2 cases (6%). The most common primary cause of death was brain injury – 17 patients (53%) followed by pelvic or spinal fractures – 5 (16%). The predominant constituents of polytrauma were bony injuries (pelvis, spine and limbs) – 28 cases (87%), followed by head injuries – 25 (78%), chest – 24 (75%) and abdominal injuries – 17 (53%). Eighteen patients (56%) required operative treatment; craniotomy for brain injuries was the most commonly performed – in 11 patients, followed by laparotomy – in 5. Five other patients underwent an endovascular procedure – pelvic artery embolization. Twelve patients (38%) died in the first two days from admission to the trauma center, 5 (16%) in the first week and 15 over one week form admission. Conclusions: Head injuries, pelvic fractures with associated retroperitoneal bleeding and severe injuries affecting several body parts were identified as the most dangerous for the survival of polytrauma patients. A trend to decrease mortality due to hemorrhagic shock was observed, but it remains unchanged for central nervous system injuries.