Trauma deaths occur in immediate, early, or late stages. Immediate deaths usually are due to apnea, severe brain or high spinal cord injury, or rupture of the heart or of large blood vessels. Early deaths occur within minutes to hours and often are due to hemorrhages in the outer meningeal layer of the brain, torn arteries, blood around the lungs, air around the lungs, ruptured spleen, liver laceration, or pelvic fracture. Immediate access to care may be crucial to prevent death in persons experiencing major trauma. Late deaths occur days or weeks after the injury and often are related to infection. Prognosis is better in countries with a dedicated trauma system where injured persons are provided quick and effective access to proper treatment facilities. Long-term prognosis frequently is complicated by pain; more than half of trauma patients have moderate to severe pain one year after injury. Many also experience a reduced quality of life years after an injury, with 20% of victims sustaining some form of disability. Physical trauma may lead to development of post-traumatic stress disorder (PTSD). One study has found no correlation between the severity of trauma and the development of PTSD.
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