Epidemiology of hemorrhage-related mortality

Abstract

Hemorrhage has been implicated as the cause of 25-30% of all injury deaths and over 80% of preventable postinjury deaths, both in the military and civilian settings. Hemorrhagic deaths are acute events, happening within the first 24 hours postinjury, mostly within 6 hours. While some studies observed a reduction in overall deaths due to exsanguination, the proportion of preventable deaths due to bleeding remains steady between close to half in civilian settings and over 80% in combat injuries. The chapter reviews the timing, location, and cause of death due to traumatic hemorrhage. Finally, we also discuss methodological difficulties in defining hemorrhagic deaths, and assessing the effect of hemostatic interventions in randomized clinical trials.