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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
  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