{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:51:15Z","timestamp":1790949075874,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Trauma is the third leading cause of death worldwide after cardiovascular and oncologic diseases. Predominant causes of trauma\u2010related death (TD) are severe traumatic brain injury (sTBI), hemorrhagic shock, and multiple organ failure. An analysis of TD is required in order to review the quality of trauma care and grasp how well the entire trauma network functions, especially for the most severely injured patients. Furthermore, autopsies not only reveal hidden injuries, but also verify clinical assumed causes of death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material<\/jats:title>\n                    <jats:p>During the study period of 3 years, a total of 517 trauma patients were admitted to our supraregional University Centre of Orthopaedics and Traumatology in Dresden. 13.7% (71\/517) of the patients died after trauma, and in 25 cases (35.2%), a forensic autopsy was instructed by the federal prosecutor. The medical records, death certificates, and autopsy reports were retrospectively evaluated and the clinical findings matched to autopsy results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The observed mortality rates (13.7%) were 4.2% less than expected by the calculated RISC II probability of survival (mortality rate of 17.9%). The most frequent trauma victims were due to falls &gt;3\u00a0m (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929), followed by traffic accidents (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200928). The median ISS was 34, IQR 25, and the median New ISS (NISS) was 50, IQR 32. Locations of death were in emergency department (23.9%), ICU (73.2%), OR and ward (1.4%, respectively). Clinicians classified 47.9% of deaths due to sTBI (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934), followed by 9.9% thoracic trauma and multiple organ failure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097), 8.4% multiple trauma (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), and 2.8% hypoxia and exsanguination (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092). In 18.3%, cases were unspecific or other causes of death recorded on the death certificates. Evident differences with evident clinical consequences were ascertained in 4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091) and marginal clinical consequences in 24% (6\/25). In 16% (4\/25), marginal differences with minor forensic consequences were revealed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Even in a supraregional trauma center, specialized in multiple trauma management (4.2% survival benefit), room for improvement exists in more than a quarter of all casualties. This underlines the need for higher autopsy rates to uncover missed injuries and to understand the pathomechanism in each trauma fatality. This would also help to uncover potential insufficiencies in clinical routines with regard to diagnostics. The interdisciplinary cooperation of trauma surgeons and forensic pathologists can increase the quality of trauma patient care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-019-05347-7","type":"journal-article","created":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T14:02:51Z","timestamp":1578924171000},"page":"1137-1148","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Synergistic Effects of Forensic Medicine and Traumatology: Comparison of Clinical Diagnosis Autopsy Findings in Trauma\u2010Related Deaths"],"prefix":"10.1002","volume":"44","author":[{"given":"Uwe","family":"Schmidt","sequence":"first","affiliation":[{"name":"Institute of Legal Medicine, Medical Faculty Carl Gustav Carus Technical University Dresden Fetscherstrasse 74 01307 Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delovan","family":"Oramary","sequence":"additional","affiliation":[{"name":"University Center of Orthopaedics and Traumatology, AG Polytrauma University Medicine Carl Gustav Carus, Technical University Fetscherstrasse 74 01307 Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Kamin","sequence":"additional","affiliation":[{"name":"University Center of Orthopaedics and Traumatology, AG Polytrauma University Medicine Carl Gustav Carus, Technical University Fetscherstrasse 74 01307 Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claas T.","family":"Buschmann","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin corporate member of Freie Universit\u00e4t Berlin, and Berlin Institute of Health, Institute of Legal Medicine and Forensic Sciences Humboldt\u2010Universit\u00e4t zu Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Kleber","sequence":"additional","affiliation":[{"name":"University Center of Orthopaedics and Traumatology, AG Polytrauma University Medicine Carl Gustav Carus, Technical University Fetscherstrasse 74 01307 Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757\u20107241\u201018\u201055"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.10.048"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2014.08.020"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cuor.2004.04.006"},{"key":"e_1_2_9_6_1","unstructured":"DavidJS BouzatP RauxMEvolution and organisation of trauma systems.Anaesth Crit Care Pain Med(2018)10.1016\/j.accpm.2018.01.00630579941"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010012\u20101650\u20109"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2009.05.006"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/scientificamerican0883\u201028"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2008.10.004"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(09)60232\u20104"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2004.09.025"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20101964\u20102"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","unstructured":"DickmannP BauerMSepsis 2019\u2014new trends and their implications for multiple trauma patients.Z Orthop Unfall(2019)10.1055\/a\u20100853\u2010205431499573","DOI":"10.1055\/a-0853-2054"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287.The"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","unstructured":"Lopes FerreiraF Peres BotaD BrossAet al. Serial evaluation of the SOFA score to predict outcome.JAMA(2001)10.1001\/jama.286.14.1754","DOI":"10.1001\/jama.286.14.1754"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010014\u20100476\u20102"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.11.004"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31802d08e5"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3180592ae8"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2017.03.068"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1197\/aemj.9.9.957"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1309\/9M7DFE62RTDKHH4D"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jflm.2012.02.00"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(07)60376\u20106"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500120063027"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.03.003"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2015.07.026"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.legalmed.2015.11.005"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12024\u2010017\u20109878\u20101"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00414\u2010015\u20101225\u2010z"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001\u2010016\u20100237\u20106"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12024\u2010014\u20109603\u20102"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102002\u201025021"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-019-05347-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-019-05347-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-019-05347-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-019-05347-7","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T05:47:58Z","timestamp":1766468878000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-019-05347-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,13]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1007\/s00268-019-05347-7"],"URL":"https:\/\/doi.org\/10.1007\/s00268-019-05347-7","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,13]]},"assertion":[{"value":"13 January 2020","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}