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Outcomes and Risk Factors for In-Hospital Mortality in Mild-to-Moderate Trauma Patients: A Nationwide Observational
Shogo Takashima1, Kazuma Yamakawa1, Ryo Yamamoto2
1Department of Emergency and Critical Care Medicine Osaka Medical and Pharmaceutical University Takatsuki Japan.
Background:
Although minor (mild-to-moderate) trauma generally leads to favorable outcomes, some patients experience in-hospital mortality. Traditional trauma severity scores alone may not sufficiently reflect the prognostic variability in aging populations with comorbidities. This study examined the associations between patient characteristics and in-hospital mortality among patients with minor trauma.
Methods:
This retrospective cohort study used data from adult patients with minor trauma, defined by an Injury Severity Score (ISS) < 16 from the Japan Trauma Data Bank. A logistic regression analysis was performed to evaluate associations between mortality and patient characteristics, including age, sex, ISS, and the Charlson Comorbidity Index (CCI) score. Subgroup analyses were conducted among patients with moderate trauma (ISS 9-15) to examine the associations between the Abbreviated Injury Scale (AIS) scores of injuries at three specific anatomical regions and in-hospital mortality.
Results:
After applying the exclusion criteria, of the 56,821 patients with ISS < 16 identified in the Japan Trauma Data Bank, 50,087 were included in the final analysis. The logistic regression analysis identified older age, male sex, ISS ≥ 9, and higher CCI scores as independent predictors of in-hospital mortality. In patients with moderate trauma, the AIS scores of injuries involving the three regions (head/neck, abdomen, and external/other trauma injury regions) were significantly associated with increased mortality.
Conclusion:
Among patients with minor trauma, advanced age, male sex, comorbidities, and specific injury regions were associated with increased in-hospital mortality. These findings highlight the importance of early risk recognition and tailored clinical management in this population.
Insights
Older age, male sex, comorbidities, and specific injury regions increase mortality risk in minor trauma patients. Early recognition and tailored management are crucial for this population.
Area of Science:
- Trauma Surgery
- Geriatric Medicine
- Public Health
Background:
- Minor trauma often results in favorable outcomes, but in-hospital mortality occurs in some cases.
- Traditional trauma severity scores may not fully capture prognostic variability in older adults with comorbidities.
- This study investigated factors associated with in-hospital mortality in minor trauma patients.
Purpose of the Study:
- To examine patient characteristics linked to in-hospital mortality in minor trauma cases.
- To identify predictors of mortality beyond standard trauma scores.
- To inform risk stratification and clinical management strategies.
Main Methods:
- Retrospective cohort study using the Japan Trauma Data Bank (n=50,087).
- Logistic regression analysis to assess associations between mortality and patient factors (age, sex, Injury Severity Score [ISS], Charlson Comorbidity Index [CCI]).
- Subgroup analysis of moderate trauma patients (ISS 9-15) examining Abbreviated Injury Scale (AIS) scores for specific anatomical regions.
Main Results:
- Older age, male sex, ISS ≥ 9, and higher CCI scores were independent predictors of in-hospital mortality.
- In moderate trauma patients, AIS scores for head/neck, abdomen, and external/other trauma regions were significantly associated with increased mortality.
- The final analysis included 50,087 patients with an ISS < 16.
Conclusions:
- Advanced age, male sex, comorbidities, and specific injury locations are associated with higher in-hospital mortality in minor trauma.
- Findings underscore the need for early risk identification in this patient group.
- Tailored clinical management strategies are essential for improving outcomes in patients with minor trauma.
