Epidemiology, mortality and morbidity in multiple trauma patients

Three hundred, twenty-nine multiple trauma patients with skeletal injuries admitted to Hennepin County Medical Center, Minneapolis were analyzed for mortality and morbidity based on injury severity score (ISS) and timing of fracture stabilization. Fifty-three deaths (16%) occurred with 38% dying during the first six hours. Survival prospects with injury severity score over 40 were bleak. Age, sex, mechanism of injury, and time of occurrence of injury was also tabulated. Two hundred, twenty-nine patients with 474 long bone fractures were analyzed based on timing of fracture stabilization: immediate stabilization within 24 hours; delayed primary stabilization over 24 hours to one week; secondary osteosynthesis more than one week; non-operative treatment. Respiratory distress syndromes occurred in 6%, 2.4%, 9%, and 12%; mortality rate of 3%, 0%, 6.4%, and 26% for treatment groups A, B, C, and D respectively. However, it must be noted that treatment group B with lower ARDS and mortality rate had no type III open fractures and lower injury severity score.