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Research Article| Volume 22, ISSUE 5, P353-356, September 1991

Preventable deaths after head injury: a clinical audit of performance

DOI:https://doi.org/10.1016/0020-1383(91)90092-S
Preventable deaths after head injury: a clinical audit of performance
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      Abstract

      A retrospective trauma audit of 267 consecutive patients presenting to the resuscitation room of an accident and emergency department identified 107 (M = 0.73) patients with CNS predominant injuries in a period of 1 year. The mortality rate was 33 per cent.
      Application of the TRISS method indicated that 18 (51 per cent) of the 35 deaths (Z = 5.74, P < 0.001) were mathematically unexpected; no unexpected survivors were identified. Subsequent peer review agreed that death was preventable in 11 cases. The peer panel suggested that the lack of an on-site neurosurgical service may have affected the outcome of this group of patients adversely.
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      References

        • American Association for Automotive Medicine
        The Abbreviated Injury Scale.
        1985 (revision. Des Plaines, Illinois)
        • Anderson I.D.
        • Woodford M.
        • De Dombal F.T.
        • et al.
        Retrospective study of 1000 deaths from injury in England and Wales.
        Br. Med. J. 1988; 296: 1305
        • Baker S.P.
        • O'Neill B.
        • Haddon W.
        • et al.
        The injury severity score: development and potential usefulness.
        in: Proceedings American Association for Automotive Medicine. 18. 1974: 58
        • Boyd C.R.
        • Tolson M.A.
        • Copes W.S.
        Evaluating trauma care: The TRISS method.
        J. Trauma. 1987; 27: 370
        • Champion H.R.
        • Sacco W.J.
        • Copes W.S.
        • et al.
        A revision of the trauma score.
        J. Trauma. 1989; 29: 623
        • Champion H.R.
        • Copes W.S.
        • Sacco W.J.
        • et al.
        A new characterization of injury severity.
        J. Trauma. 1990; 30: 539
        • Copes W.S.
        • Sacco W.J.
        • Champion H.R.
        Guest Editorial.
        Arch. Emerg. Med. 1989; 6: 165
        • Dearden C.H.
        • Rutherford W.H.
        The resuscitation of the severely injured in the Accident and Emergency Department — a medical audit.
        Injury. 1985; 16: 249
        • Gennarelli T.A.
        • Spielman G.M.
        • Langfitt
        • et al.
        Influence of the type of intracranial lesion on outcome from severe head injury.
        J. Neurosurg. 1982; 56: 26
        • Gennarelli T.A.
        • Champion H.R.
        • Sacco W.J.
        • et al.
        mortality of patients with head injury and extracranial injury treated in trauma centers.
        J. Trauma. 1989; 29: 1193
        • Harviel J.D.
        • Landsman I.
        • Greenberg A.
        • et al.
        The effect of autopsy on injury severity and survival probability calculations.
        J. Trauma. 1989; 29: 766
        • Luerssen T.G.
        • Klauber M.R.
        • Marshall L.F.
        Outcome from head injury related to patient's age.
        J. Neurosurg. 1988; 68: 409
        • Miller E.S.
        • Neoptolemos J.P.
        • Aitkenhead A.R.
        • et al.
        Management of severe head injuries in a non-neurosurgical trauma centre.
        J. R. Coll. Surg. Edinb. 1985; 30: 82
        • Pories S.E.
        • Gamelli R.L.
        • Pilcher D.B.
        • et al.
        Practical evaluation of trauma deaths.
        J. Trauma. 1989; 29: 1607
        • Royal College of Surgeons of England
        Commission on the provision of surgical services. Report of the Working Party on the Management of Patients with Major Injuries. 1988; (London)
        • Royal College of Surgeons of England
        Commission on the provision of surgical services. Report of the Working Party on Head Injuries. 1986; (London)
        • Teasdale G.
        • Jennet B.
        Assessment of coma and impaired consciousness. A practical scale.
        Lancet. 1974; 2: 81
        • Teasdale G.
        • Galbraith S.
        • Murray L.
        • et al.
        Management of traumatic intracranial haematoma.
        Br. Med. J. 1982; 295: 1695
        • Teasdale G.M.
        • Murray G.
        • Anderson E.
        • et al.
        Risks of acute traumatic intracranial haematoma in children and adults: implications for managing head injuries.
        Br. Med. J. 1990; 300: 363

      Article info

      Publication history

      Accepted: January 11, 1991

      Identification

      DOI: https://doi.org/10.1016/0020-1383(91)90092-S

      Copyright

      © 1991 Published by Elsevier Inc.

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