DECREASES IN PREVENTABLE TRAUMA DEATHS OVER TIME DUE TO TRAFFIC ACCIDENTS IN CHIBA PREFECTURE AND DIFFERENCES IN TRAUMA CARE OUTCOMES AMONG EMERGENCY CRITICAL CARE CENTERS DURING 2009-2019

• Published in: Journal of the Japanese Association for the Surgery of Trauma Vol. 37; no. 3; pp. 279 - 288
• Main Authors: MOTOMURA, Tomokazu, HIRABAYASHI, Atsushi, KUJO, Masanori, SAKAMOTO, Taigo, FUNAKI, Yutaka, YASUMATSU, Hiroshi, MASHIKO, Kazuki, YAGI, Takanori, HARA, Yoshiaki, YOKOBORI, Shoji
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Association for the Surgery of Trauma 20.07.2023; 一般社団法人 日本外傷学会
• Subjects: circulation management; hemostasis; peer review; trauma center; 事例検討会; 外傷センター; 循環管理; 止血術
• ISSN: 1340-6264; 2188-0190
• DOI: 10.11382/jjast.37.3_11

BackgroundThe quality of trauma care has not been evaluated over time in Japan.Target and methodAmong deaths within 24 h of traffic accidents in Chiba Prefecture during 2009-2019, patients with signs of life (SOL+) at contact with emergency medical services were analyzed. Data were collected from police, fire departments, and medical institutions. Each case was classified by a peer review as preventable trauma death (PTD), potentially PTD (p-PTD), or not preventable.The following hypotheses were examined.(1) The ratio of PTD and p-PTD (PTD rate) decreased over time.(2) PTD and p-PTD involved problems with circulatory management and hemostasis.(3) The PTD rate was lower at emergency critical care centers with a high volume of SOL+.ResultsOf 785 deaths, 65 were classified as PTD and 86 as p-PTD.All three hypotheses were supported. Problems with circulatory management and/or hemostasis in the emergency department were identified in 70 cases of PTD/p-PTD (46%).ConclusionThe PTD rate decreased over time in traffic accident deaths in Chiba Prefecture. Many PTD/p-PTD cases were found to involve problems with circulatory management and hemostasis in the emergency department.