Characteristics of patients with trauma who died in hospital in Nova Scotia, 2009/10 to 2015/16
| Characteristic | Potential organ donors, no. (%)*† | p value‡ | Not potential organ donors, no. (%) n = 415 | p value§ | ||
|---|---|---|---|---|---|---|
| Total n = 274 | Referred to Legacy of Life Program n = 108 | Not referred to Legacy of Life Program n = 166 | ||||
| Age, yr, mean ± SD | 55.6 ± 23.5 | 44.7 ± 20.5 | 61.4 ± 23.5 | < 0.001 | 71.9 ± 20.9 | < 0.001 |
| Male sex | 200 (73.0) | 85 (78.7) | 115 (69.3) | 0.1 | 265 (63.8) | 0.01 |
| Residence | 0.9 | 0.4 | ||||
| Urban | 185 (67.5) | 73 (67.6) | 112 (67.5) | 290 (69.9) | ||
| Rural | 85 (31.0) | 33 (30.6) | 52 (31.3) | 123 (29.6) | ||
| Missing | n < 5 | n < 5 | n < 5 | n < 5 | ||
| Injury location | 0.8 | 0.9 | ||||
| Within Halifax Regional | 95 (34.7) | 39 (36.1) | 56 (33.7) | 150 (36.1) | ||
| Municipality | ||||||
| Outside Halifax Regional | 163 (59.5) | 62 (57.4) | 101 (60.8) | 241 (58.1) | ||
| Municipality | ||||||
| Missing | 16 (5.8) | 7 (6.5) | 9 (5.4) | 24 (5.8) | ||
| No. of intermediate facilities | 0.003 | < 0.001 | ||||
| 0 | 141 (51.4) | 45 (41.7) | 96 (57.8) | 283 (68.2) | ||
| 1 | 117 (42.7) | 56 (51.8) | 61 (36.7) | 81 (19.5) | ||
| ≥ 2 | 16 (5.8) | 7 (6.5) | 9 (5.4) | 29 (7.0) | ||
| Missing | 0 (0) | 0 (0) | 0 (0) | 22 (5.3) | ||
| Injury type | < 0.001 | < 0.001 | ||||
| Blunt | 242 (88.3) | 84 (77.8) | 158 (95.2) | 334 (80.5) | ||
| Drowning/asphyxia | 23 (8.4) | 17 (15.7) | 6 (3.6) | 21 (5.1) | ||
| Other | 9 (3.3) | 7 (6.5) | n < 5 | 60 (14.4) | ||
| Injury cause | 0.002 | < 0.001 | ||||
| Fall | 116 (42.3) | 35 (32.4) | 81 (48.8) | 247 (59.5) | ||
| Motor vehicle collision | 75 (27.4) | 26 (24.1) | 49 (29.5) | 50 (12.0) | ||
| Self-harm | 30 (10.9) | 18 (16.7) | 12 (7.2) | 17 (4.1) | ||
| Other¶ | 53 (19.3) | 29 (26.8) | 24 (14.4) | 101 (24.3) | ||
| ICD-10-CA injury code** | 0.004 | < 0.001 | ||||
| Traumatic subdural hemorrhage | 192 (70.1) | 74 (68.5) | 118 (71.1) | 153 (36.9) | ||
| Traumatic subarachnoid | 154 (56.2) | 62 (57.4) | 92 (55.4) | 85 (20.5) | ||
| hemorrhage | ||||||
| Focal brain injury | 117 (42.7) | 54 (50.0) | 63 (38.0) | 44 (10.6) | ||
| Fracture, base of skull | 101 (36.9) | 52 (48.1) | 49 (29.5) | 20 (4.8) | ||
| Fracture, vault of skull | 70 (25.5) | 38 (35.2) | 32 (19.3) | 23 (5.5) | ||
| Traumatic cerebral edema | 59 (21.5) | 34 (31.5) | 25 (15.1) | 14 (3.4) | ||
| Diffuse brain injury | 52 (19.0) | 28 (25.9) | 24 (14.4) | n < 5 | ||
| Other | 116 (42.3) | 38 (35.2) | 78 (47.0) | 89 (21.4) | ||
| Comorbidities†† | 0.001 | < 0.001 | ||||
| Cardiac/vascular | 107 (39.1) | 19 (17.6) | 88 (53/0) | 257 (61.9) | ||
| Neurological | 51 (18.6) | 21 (19.4) | 30 (18.1) | 92 (22.2) | ||
| Renal | 21 (7.7) | 0 (0) | 21 (12.6) | 40 (9.6) | ||
| Infectious disease | 19 (6.9) | n < 5 | n > 5‡‡ | 113 (27.2) | ||
| Respiratory | 18 (6.6) | n < 5 | n > 5‡‡ | 49 (11.8) | ||
| Neoplastic | 17 (6.2) | 5 (4.6) | 12 (7.2) | 68 (16.4) | ||
| Gastrointestinal | 9 (3.3) | n < 5 | n > 5‡‡ | 39 (9.4) | ||
| Other | 125 (45.6) | 39 (36.1) | 86 (51.8) | 185 (44.6) | ||
| Injury severity | ||||||
| Injury Severity Score, mean ± SD | 28.5 ± 12.1 | 29.3 ± 11.5 | 27.7 ± 12.5 | 0.04 | 20.7 ± 11.0 | < 0.001 |
| Abbreviated Injury Scale, Head, mean ± SD | 4.5 ± 0.7 | 4.8 ± 0.5 | 4.3 ± 0.8 | < 0.001 | 3.9 ± 1.3 | < 0.001 |
| Scene Glasgow Coma Scale, mean ± SD | 6.9 ± 4.6 | 5.1 ± 3.5 | 8.0 ± 4.9 | < 0.001 | 11.0 ± 4.9 | < 0.001 |
| Trauma team activation | 113 (41.2) | 59 (54.6) | p (32.5) | < 0.001 | 55 (13.2) | < 0.001 |
| Transport to final institution | < 0.001 | < 0.001 | ||||
| Land | 194 (70.8) | 60 (55.6) | 134 (80.7) | 359 (86.5) | ||
| Air§§ | 53 (19.3) | 34 (31.5) | 19 (11.4) | 13 (3.1) | ||
| Both land and air | 22 (8.0) | 13 (12.0) | 9 (5.4) | 12 (2.9) | ||
| Other¶¶ | n < 5 | n < 5 | n < 5 | 12 (2.9) | ||
| Missing | n < 5 | n < 5 | n < 5 | 19 (4.6) | ||
| Hospital stay | ||||||
| Intensive care unit admission | 183 (66.8) | 85 (78.7) | 98 (59.0) | < 0.001 | 76 (18.3) | < 0.001 |
| Intensive care unit length of stay, d, mean ± SD | 4.4 ± 5.2 | 3.1 ± 3.0 | 5.9 ± 6.6 | 0.001 | 4.7 ± 7.3 | 0.7 |
| Hospital length of stay, d, mean ± SD | 7.0 ± 27.8 | 3.1 ± 3.1 | 9.3 ± 34.7 | 0.004 | 9.3 ± 21.1 | 0.2 |
| Ventilator days, mean ± SD | 2.9 ± 3.6 | 3.0 ± 3.0 | 2.8 ± 4.0 | 0.001 | 3.4 ± 5.2 | 0.3 |
| Institution where patient died | < 0.001 | < 0.001 | ||||
| Queen Elizabeth II Health Sciences Centre | 214 (78.1) | 102 (94.4) | 112 (67.5) | 211 (50.8) | ||
| Other | 60 (21.9) | 6 (5.6) | 54 (32.5) | 204 (49.2) | ||
Note: ICD-10-CA = International Statistical Classification of Diseases and Related Health Problems, 10th revision, Canada, SD = standard deviation.
↵* In keeping with the privacy policy of the Nova Scotia Department of Health and Wellness, any counts less than 5 are suppressed and reported as n < 5.
↵† Except where noted otherwise.
↵‡ Significance for comparison of potential organ donors referred to Legacy of Life Program versus those not referred.
↵§ Significance for comparison of total potential organ donors versus patients who were not potential organ donors.
↵¶ Includes penetrating injuries and burns.
↵** From the Nova Scotia Trauma Registry definition of a potential organ donor (Appendix 1). Some patients had multiple injury codes.
↵†† Some patients had multiple comorbidities.
↵‡‡ To prevent calculation of numbers.
↵§§ Includes helicopter and fixed-wing aircraft.
↵¶¶ Includes private vehicle and walk-in.