J.Jpn. Surg. Soc.. 82(8): 918-924, 1981

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Original article

ETIOLOGY OF EARLY DEATHS WITHIN 24 HOURS AFTER ADMISSION

Early deaths from trauma must be one of the most significant problems in the field of critical care medicine. During the past 5 years, 758 patients with trauma were admitted to the trauma intensive care unit of Osaka University Hospital. One-hundred and seventy-four patients were dead and 62 of then died within 24 hours after admission. This study was undertaken to examine the factors affecting early deaths closely. The conclusions are as follows;
1) 39.1 % of the patients with multiple injury were dead within 24 hours after admission and 40.4% of the patients who died within 24 hours were due to multiple injuries.
2) The most common cause of inijury leading to death within 24 hours was motor vehicle accident (50.0%), and then fall (32.3%). The latter resulted in earlier death than the former.
3) 52 patients (84.6%) died of head trauma in monosite injury and among multiple injured patients most of early death were due to chest and abdominal injuries.
4) The ultimate causes of early death were brain damage and hemorrhage. Thirty two cases (51.6%) died of brain damage and 26 (41.9%) of hemorrhage. Patients with fatal hemorrhage died earlier after admission than those with brain damage. We presume 8 hours after admission may be critical time in the treatment of hemorrhagic shock.

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