Short-term versus long-term trauma mortality: A systematic review.

Area of Science:

• Trauma care and outcomes research
• Public health and epidemiology
• Geriatric medicine

Background:

• Trauma is a leading cause of death across age groups in the US.
• While 30-day trauma mortality has decreased to <4%, long-term outcomes show higher mortality rates (>20%).
• A significant incongruence exists between short-term survival improvements and long-term mortality in trauma patients.

Purpose of the Study:

• To systematically review and analyze the discrepancy between short-term and long-term mortality in trauma patients.
• To investigate factors contributing to the observed differences in survival rates.
• To assess the correlation between advancements in clinical care and long-term patient outcomes.

Main Methods:

• Systematic review of English, German, French, and Portuguese articles.
• Searched multiple databases including Cochrane Library, EMBASE, Ovid Medline, Google Scholar, and Web of Science.
• Included studies published from 1965 to 2018.

Main Results:

• Trauma patients exhibit decreased long-term survival compared to the general and age-matched populations.
• Post-discharge mortality rates are significantly higher in trauma patients (e.g., 26.3% at 5-25 years) versus controls (15.6%).
• Comorbidities and discharge to skilled nursing facilities are associated with worse long-term outcomes.

Conclusions:

• Improved short-term trauma mortality does not correlate with improved long-term survival.
• The role of initial trauma, aging population, comorbidities, and discharge destination in long-term mortality requires further investigation.
• Current evidence quality is insufficient to confirm improvements in long-term trauma mortality outcomes.