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May 25, 1984

Care of Serious Trauma in Southern Sweden

Author Affiliations

University of California, Davis, School of Medicine Sacramento

JAMA. 1984;251(20):2698-2699. doi:10.1001/jama.1984.03340440056030

Ottosson and Krantz1 in a retrospective review of all deaths from motor vehicle accidents in 1981 in southern Sweden concluded only three of 159 were preventable. They attributed their excellent results to a decentralized prehospital and hospital system of care.

Before examining the features of the Swedish system of trauma care that might have application in the United States, we ought to scrutinize the claim made by the authors that only three of 159 deaths were preventable. The subjective determination as to whether a death was preventable, nonpreventable, or possibly preventable was made by the authors, all experienced forensic pathologists, using the delphi technique. Their judgments were buttressed through use of the Abbreviated Injury Scale 80 (AIS 80) and its injury severity counterpart, the Injury Severity Score (ISS) developed by Susan Baker. The absence of general surgeons or neurosurgeons among the authors of this report and the authors' decision