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1375 An analysis of the certified cause of death within one year of serious injury in the Scottish population
  1. Hannah Craig1,
  2. Malcolm WG Gordon2,
  3. Angela Khan3
  1. 1University of Glasgow
  2. 2NHS UK
  3. 3Public Health UK


Aims, Objectives and Background To date, few studies effectively quantify the long-term incidence of death directly related to injury.

The absence of detailed mortality data and underlying cause of death information following trauma results in an inadequate understanding and a potential underestimation of the true consequences of injury on an individual and population level.

This study takes a nationwide approach to identify the true one-year mortality in patients due to serious injury in Scotland, evaluating survivorship in relation to other pre-existing co-morbidities and incidental causes of death.

Method and Design This retrospective cohort study assessed the one-year mortality of adult trauma patients with an Injury Severity Score > 9 during 2020 using the Scottish Trauma Audit Group (STAG) registry linked to inpatient hospital data and death certificate records. Patients were divided into three distinct subgroups: death due to injury, death due to another cause, but injury was a contributory factor, and death due to a separate cause. These were subsequently analysed to determine risk factors linked to death. Kaplan-Meier curves and Cox regression were used for survival analysis to evaluate mortality.

Abstract 1375 Figure 1

Kaplan-Meier survival curve of the 2020 STAG cohort of traumatically injured adult patients who died within 365 days post-trauma hospitalisation stratified by underlying cause of death subgroup: trauma, trauma-contributed and non-trauma

Results and Conclusion 4056 patients were analysed with a median age 63 years and male predominance (55.2%). 782 patients died within 365 days (19.3%), with 55% occurring post-discharge. 47.7% of all deaths were attributable to trauma, and 35.3% were a direct consequence of injury. Non-traumatic deaths accounted for 20.3% and 79.4% in-hospital and post-discharge deaths respectively, most frequently due to circulatory, neoplastic and respiratory disease (37.7%, 12.3%, 9.1%, respectively). GCS < 8, modified Charlson Comorbidity score > 5, Injury Severity Score >25, Head AIS >3, Sex, and Age were independent risk factors for mortality at one year. Approximately 20% of patients died within 365 days due to trauma. Although early deaths reflect the bulk of trauma-related mortality, our sample demonstrated a significantly higher post-discharge one-year mortality than previously appreciated.

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