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Title: An analysis of deaths following trauma in Scotland
Author: Wyatt, Jonathan Paul
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2000
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The principal objectives of this thesis were to examine how, where and why deaths occur after trauma in Scotland, with a view to seeing how future deaths might be prevented. This investigation comprised a detailed analysis of several thousand trauma deaths, concentrating upon background circumstances of the traumatic episodes, timing of deaths, severity and pattern of injuries sustained, forensic and medicolegal aspects and treatment provided. Data sources included prospectively collected data from the Scottish Trauma Audit Group, Accident and Emergency, Procurator Fiscal and Forensic Medicine units. Injuries were scored and analysed according to the Abbreviated Injury Scale (1990 revision). The large number of deaths confirmed official figures, demonstrating that road traffic collisions, falls, hangings, drownings, fires and assaults were responsible for 885 of trauma deaths. Analysis of the timing of these deaths in Lothian and Borders regions of Scotland revealed that 76% died before reaching hospital, with the vast majority being either dead when found or having injuries acknowledged to be unsurvivable using the Abbreviated Injury Scale. Findings in south-east Scotland were mirrored elsewhere in Scotland. These findings challenge the previously accepted concept of a trimodal distribution of trauma deaths and indicate that overall, there is a greater potential to reduce the death rate through injury prevention measures rather than through improved prehospital or hospital treatment. A national prospective study of 1305 Scottish trauma deaths in 1995 implicated alcohol in causing a large proportion of deaths. Injury prevention measures aimed at reducing the trauma death rate need to focus upon the role of alcohol, taking into account the fact that it is difficult to modify the behaviour of individuals once under the influence of alcohol. The way forward appears to lie with injury prevention measures combining legislation, advances in engineering and technology with community education and health promotion.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available