In-Hospital Mortality after Massive Transfusion and Motorcycle Trauma may Predict Highest Injury Severity in a Rural Level I Trauma System

The leading cause of preventable traumatic death is uncontrolled bleeding. This study aimed to better identify those most likely to experience in-hospital mortality with increasing injury severity scoring (ISS). This is a single-center study of Trauma Registry data, from July 3, 2016, to February 24, 2022. The inclusion criteria were based upon age (≥18 years) and in-hospital mortality. 546 patients (mean age 58) were included in the analysis. There were several significant associations with increasing ISS among those who experienced in-hospital mortality, which included a rising shock index ratio, activation of the massive transfusion protocol, and, most notably, motorcycle trauma. This research reiterates the importance of the “Stop the Bleed” campaign as vital for training laypersons in the life-saving technique for hemorrhage control.