Is the trimodal pattern of death after trauma a dated concept in the 21st century? Trauma deaths in Auckland 2004

Objective: To determine whether the classical trimodal distribution of trauma deaths is still applicable in a contemporary urban New Zealand trauma system. Methods: All trauma deaths in the greater Auckland region between 1 January 2004 and 31 December 2004 were identified and reviewed. Data was obtained from hospital trauma registries, coroner autopsy reports and police reports. Results: There were 186 trauma deaths., The median age was 28.5 years and the median Injury Severity Score was 25. The predominant mechanisms of injury were hanging (36%), motor vehicle crashes (31.7%), falls (9.7%), pedestrian-vehicle injury (5.4%), stabbing (4.3%), motorcycle crashes (3.2%), and pedestrian-train injury (2.2%). Most deaths were from central nervous system injury (71.5%), haemorrhage (15.6%), and airway/ventilation compromise (3.8%). Multi-organ failure accounted for 1.6% of deaths. Most deaths occurred in the pre-hospital setting (80.6%) with a gradual decrease thereafter. Conclusion: There was a skew towards early deaths. The trimodal distribution of trauma deaths was not demonstrated in this group of patients. (c) 2007 Elsevier Ltd. All rights reserved.