critical procedures are left until the victim is more stable. Approximately 15% of all people with trauma have abdominal injuries, and approximately 25% of these require exploratory surgery. The majority of preventable deaths from trauma result from unrecognised intra-abdominal bleeding. Prognosis 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. Epidemiology Trauma is the sixth leading cause of death worldwide, resulting in five million or 10% of all deaths annually. It is the fifth leading cause of significant disability. About half of trauma deaths are in people aged between 15 and 45 years and trauma is the leading cause of death in this age group. Injury affects more males; 68% of injuries occur in males and death from trauma is twice as common in males as it is in females, this is believed to be because males are much more willing to engage in risk-taking activities. Teenagers and young adults are more likely to need hospitalization from injuries than other age groups. While elderly persons are less likely to be injured, they are more likely to die from injuries sustained due to various physiological differences that make it more difficult for the body to compensate for the injuries. The primary causes of traumatic death are central nervous system injuries and substantial blood loss. Various classification