Mortality in patients with loss of consciousness at the scene of trauma

BACKGROUND AND AIM The aim of this study was to evaluate if loss of consciousness at the scene of an accident in patients with thoracic trauma classified by the Abbreviated Injury Scale (AIS) as thorax >2 has a different outcome in respect to immediate hospital discharge, hospitalization, death and type of accident. METHODS A prospective study was performed in the Regional Trauma Center of São José do Rio Preto. All patients with scores related to thoracic injury >/=2 were included in this study. Thus, 134 patients with penetrating and 231 with blunt thoracic injuries were evaluated. The chi-square, Fisher's exact and relative risk tests were utilized for statistical analysis with an alpha error greater than 5% (p < 0.05) being considered statistically significant. RESULTS A significantly higher number of patients who lost consciousness (35-33.9%) died compared to those who did not lose consciousness (9-3.5%, Fisher's exact test: p < 0.0001) where the relative risk (RR) of death when an individual lost consciousness was 9.7 (95% CI: 4.8-19.4). In respect to the necessity of hospital treatment, those who lost consciousness were more commonly hospitalized (Fisher's exact test: p < 0.0001). CONCLUSION The loss of consciousness at the time of trauma is a warning sign in patients with thoracic injuries whether associated with other types of injuries or not.