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August 23, 1985

Preventable Trauma Deaths: A Review of Trauma Care Systems Development

Author Affiliations

From the Division of Emergency Medicine, Oregon Health Sciences University, Portland, and the Department of Internal Medicine, California College of Medicine, University of California, Irvine (Dr Cales); and the Department of Surgery, University of California, San Francisco (Dr Trunkey).

JAMA. 1985;254(8):1059-1063. doi:10.1001/jama.1985.03360080071032

ACCIDENTAL death, characterized as the neglected disease of modern society,1 is the leading mortality cause for persons 1 through 39 years of age and the third for those of all ages.2

Because of the medical, social, and economic implications of trauma, attention is increasingly focusing on a systems approach to reducing traumatic death and disability through prevention, treatment, and research.3-5 Regional trauma care systems have not been universally implemented, however, because of concerns about need, efficacy, and cost.

This review traces the evolution of the preventable death concept, discusses its influence on trauma care systems development, and proposes future research directions.

HISTORICAL REVIEW  The American College of Surgeons first addressed trauma care in 1922 by forming the Committee on Treatment of Fractures, now the Committee on Trauma.6 Excepting the military experience,7 however, care quality for the multiply injured received relatively little attention during the next