Trauma: Epidemiology & Etiology

Epidemiology & Etiology

Trauma Epidemiology

  • Third Leading Cause of Death in the US
  • Most Common Cause of Death in Ages 1-44 Years
  • Most Common in Young Males

Trauma Etiology

  • Causes of Traumatic Deaths:
    • Motor Vehicle Collision (MVC) #1
    • Falls #2
    • Gun-Shot Wounds (GSW) #3
      • Suicide Rate Almost Double the Homicide Rate
  • Blunt Trauma
    • Motor Vehicle Collision (MVC) #1
    • Falls #2
  • Penetrating Trauma
    • Stab Wounds Most Common
    • Gun-Shot Wounds (GSW) 8-Times More Lethal
  • Proportionality:
    • Total Presentations: 90% Blunt, 10% Penetrating
    • Total Trauma Deaths: 80% Blunt, 20% Penetrating
    • Total Requiring Laparotomy: 67% Blunt, 33% Penetrating

Trauma Deaths

Trauma Death Peaks

  • First Peak: Within Minutes
    • Most Common Cause: Hemorrhage (#1 in First Hour)
    • Usually Too Quick to Save
  • Second Peak: Hours
    • Most Common Cause: TBI (#1 if Reach Hospital) & Hemorrhage
    • The “Golden Hour” of Trauma
  • Third Peak: Days-Weeks
    • Most Common Cause: Infection & Multi-System Organ Failure

Lethal Triad

  • Triad:
    • Coagulopathy
    • Acidosis
    • Hypothermia
  • Positive Feedback Loop with Significantly Increased Mortality
  • Coagulopathy Occurs Before Resuscitation/Hospital Arrival
  • “Lethal Diamond”
    • Also Includes Hypocalcemia
    • Due to Blood Loss & Exacerbated by Resuscitation with Blood Products