Objective To explore preventable death rate and its influencing factors among trauma patients in Shenzhen city during 2014 and to provide evidences for improving trauma treatment.
Methods We collected the data on all trauma-related deaths occurred within three days of emergency medical treatment in Shenzhen city in 2014. Two experts assessed all records of the data to determine each of the preventable or unpreventable deaths and factors associated with the deaths. We analyzed 12 indicators which could affect the preventable deaths and categorized preventable death-related factors suggested by the experts.
Results Of all trauma deaths occurred during pre-hospital or in-hospital emergency medication in 83 medical institutions during 2014 in the city, 238 were eligible to be included in the study, of which, 66 were judged as preventable deaths and the preventable death rate was 27.73%. Logistic regression analyses revealed that significant risk factors for preventable trauma death included injury occurred in a public place (odds ratio OR = 2.101, P = 0.045), injury caused by other than falling (OR = 12.784, P = 0.001), with an inter-hospital transfer (OR = 6.836, P = 0.002), death at emergency department (OR = 5.778, P < 0.001), and death caused by other than brain injury (OR = 4.831, P < 0.001). The results of experts assessment indicated that among all the preventable death-related problematic medical treatments, 50.37% appeared in emergency departments and 95.59% were related to medication processes; for all the inpatient preventable deaths, 50% of the problematic medical treatments were related to the system of emergency medication.
Conclusion The preventable death rate in Shenzhen city is higher than that in the developed countries mainly because of the green channel for emergency medical service system has not yet been successfully established and standardized emergency medications are not carried out; the results suggest that of the trauma care system in Shenzhen may need to be redesigned.
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