Neurologic — head trauma | Death due to intracranial abnormality, including the anatomic injury itself (e.g., contusion) or a secondary consequence of the injury (e.g., severe cerebral edema) | 29 (27) |
Cardiac failure | Death due to cardiac failure, including myocardial infarction or contusion, arrhythmia, congestive heart failure or pulmonary embolism | 7 (6) |
Respiratory failure | Death due to respiratory failure, including respiratory arrest, adult respiratory distress syndrome, inhalation injury, any pulmonary or ventilation insufficiency | 7 (6) |
Hemorrhage | Death due to uncontrolled bleeding, regardless of organ, but exclusive of the brain (e.g., a massive subdural hemorrhage should be coded to neurologic — head trauma). | 16 (15) |
Spinal cord trauma | Death due to spinal cord injury, usually an atlanto-occipital dislocation | 1 (1) |
Other | Death due to any other cause not listed above. (12 of the 20 other cases were the result of multiple trauma.) | 20 (19) |
Sepsis/systemic inflammatory response syndrome (SIRS) | Death due to the systemic inflammatory response to infection caused by the presence of microorganisms in the host (sepsis) or the a variety of noninfectious pathologic causes, including multiple trauma and tissue injury or hemorrhagic shock. The response is manifested by 2 or more of the following:
temperature > 38 °C or < 36 °C heart rate > 90 bpm respiratory rate > 20 bpm or Paco2 < 32 mm Hg Leukocyte count > 12.0 × 109/L, < 4.0 × 109/L or > 10% immature forms. Severe forms may also include hypotension or hypoperfusion abnormality (e.g., lactic acidosis, oliguria, acute alteration of mental status). | 18 (17) |
Multiple organ dysfunction syndrome (MODS) | Death due to altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention. May be primary, a direct result of a well-defined insult (e.g., trauma/pulmonary contusion) in which organ dysfunction occurs early and can be directly attributable to the insult itself; or secondary, as a consequence of a host response and is identified within the context of sepsis/SIRS. | 10 (9) |