الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Traumatic injury and trauma deaths are considered a major health problem all over the world. The management of multiply injured trauma patients is a skill requiring broad knowledge, remarkable skills and rapid systematic approach. Trauma care creates a perfect storm for medical errors: unstable patients, incomplete histories, time-critical decisions, concurrent tasks, involvement of many disciplines, and often junior personnel working after-hours in busy emergency departments.
The second peak in the trimodal distribution of trauma deaths is early deaths; include deaths within 24 hours of arrival to a trauma centre. These deaths are a consequence of severe injuries like hemorrhagic injuries of abdominal organs or expanding intracranial mass lesions, but the patients arrive at the hospital alive and are potentially treatable with prompt definitive care. The aim of good trauma care is to prevent early trauma mortality.
The present study was a prospective one performed on patients suffered from major blunt polytrauma who admitted to the Emergency Department of the Alexandria Main University Hospital for a period of six months from July the first to December the thirty first 2012.
The aim of the current study was to identify and assess factors leading to early deaths following major blunt polytrauma. During the period of the study 58 patients who died within the first 24 hours of hospital admission and met the inclusion criteria were the study population.
The data included were the patient personal data (age, gender, premorbid conditions), mechanism of injury, time elapse between trauma and arrival, vital signs, severity of injury which assessed anatomically by injury severity score ISS and physiologically by revised trauma score RTS with its parameters (systolic blood pressure, respiratory rate and GCS), ABG analysis, laboratory investigation, radiological investigations, analysis of early stages of hospital management to determine errors in management, the most probable cause of death, time of death and probability of survival using Trauma Score - Injury Severity Score (TRISS) method.
During the period of the study 899 patients suffered from major blunt polytrauma admitted to the Emergency Department of the Alexandria Main University Hospital,116 patients died in the emergency department including (ICU and OR) representing (12.9%), out of these total deaths, 86 patients died in the first twenty four hours after admission representing (74.1%) of total deaths. Out of them, only 58 patients met the inclusion criteria of the current study, 39 patients were males representing (67.2%) and 19 patients were females representing (32.8%) with male to female ratio of 2.1:1.
Regarding age distribution, in our study the age group from 18 to 55 years was the most common age group affected representing (60.3%) of patients.
RTA was the most common mechanism of injury in our study in 29 patients representing 50% followed by fall from height in 17 patients representing 29.3%, also RTA was the predominant cause in all age groups except for pediatric age group (< 18 years) in which fall from height was the commonest mechanism of injury.