• Oliver von Olnhausen, Andreas Wladis, and Denise Bäckström.
• Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
• Scand J Trauma Resus. 2024 Sep 26; 32 (1): 9696.

BackgroundHaemorrhage is a leading cause of preventable mortality in high-income countries and emergency management presents unique challenges in the prehospital setting. The study aimed to determine incidence and characteristics of fatalities from prehospital haemorrhage in Sweden.MethodsA nationwide retrospective cohort study 2012-2021 was conducted using data from the Swedish National Board of Health and Welfare. Prehospital fatality from haemorrhage was defined as a cause of death related to haemorrhage (Appendix 1) without a hospital admission on the same day. Primary outcome was age-standardized mortality rate per 100,000 inhabitants.ResultsA total of 9801 prehospital fatalities from haemorrhage were identified. Annual age-standardized mortality rate decreased from 10.97 to 8.18 per 100,000 population (coefficient =  - 0.28, r2 = 0.85, p =  < 0.001). Trauma was the most common cause (3512, 35.83%) with intentional self-harm (X60-X84), transport accidents (V01-V99) and assault (X85-Y09) being the most common mechanisms of injury. Traumatic fatalities were younger and a larger proportion were male compared to non-traumatic causes (p < 0.001). Overall median Charlson Comorbidity Index (Quan) was 0 [0-2] with a lower index noted for traumatic causes (p < 0.001). Trauma resulted in a median of 26.1 [3.65-49.22] years of life lost per patient compared to 0 [0-3.65] for non-traumatic causes (p < 0.001). Regional variations in mortality rate were observed with lower population density correlating with higher mortality rate (ρ =  - 0.64, p = 0.002).ConclusionsPrehospital mortality from haemorrhage decreased between 2012 and 2021. Trauma was the most common cause which resulted in many years of life lost in a population with a low burden of comorbidities. There were considerable regional differences with low population density associated with higher mortality rate from prehospital haemorrhage.© 2024. The Author(s).

29 keywords...

hide…