Table 2 Why do trauma patients die? Exploring contributors to death by Delphi consensus by national and international panel of experts
From: Learning from 2523 trauma deaths in India- opportunities to prevent in-hospital deaths
|  | Least to most relevant Score 1–10 | |
|---|---|---|
| Â | International experts | Indian researchers |
1. Where there is no system of trauma care, with the existing available resources & information, the following are the most probable reasons for in-hospital trauma deaths in India: | ||
Delayed control of haemorrhage-Intra-abdominal and pelvic Haemorrhage | 10 | 8 |
Delayed control of haemorrhage-Intra-thoracic Haemorrhage | 10 | 8 |
Delayed control of haemorrhage-Extremity Haemorrhage | 5 | 6 |
Delayed resuscitation | 10 | 10 |
Inadequate resuscitation | 10 | 10 |
Lack of blood | 7 | 10 |
Inadequate monitoring of vitals | 8 | 10 |
2. With poor GCS, the probable reasons why trauma patients with poor GCS die early within days are: | ||
Overwhelming impact of Traumatic Brain injuries | 8 | 8 |
Uninvestigated Head injury | 8 | 2 |
Untreated Head Injury-no surgery done | 8 | 6 |
Inadequate airway management | 6 | 10 |
Inadequate ventilatory management | 10 | 10 |
Decision not to operate-left to die | 6 | 5 |
3. Systemic issues which contribute to death in trauma patients in urban Indian hospitals: | ||
Prehospital delay contributing to in-hospital mortality | 8 | 8 |
Lack of basic investigations | 6 | 4 |
Lack of advanced imaging facilities | 2 | 4 |
Lack of ventilator | 6 | 10 |
Unduly long surgery done | 2 | 4 |
Inappropriate surgery done | 4 | 6 |
Unstable patient operated on | 4 | 3 |
Unstable patient sent for CT or USG | 4 | 6 |
Lack of protocols | 8 | 10 |
Lack of adherence to protocols | 10 | 8 |
4. The long-term reasons why trauma patients die in the weeks following admission are: | ||
Quite unknown | 10 | 8 |
Sepsis | 8 | 8 |
Ventilator related complications | 3 | 10 |
Pneumonia | 8 | 10 |
DIC | 2 | 4 |