Ten-year trends in traumatic injury mechanisms and outcomes: A trauma registry analysis

Khorgami, Zhamak; Fleischer, William J.; Chen, Yuen-Jing A.; Mushtaq, Nasir; Charles, Michael S.; Howard, C. Anthony

doi:10.1016/j.amjsurg.2018.01.008

Cited by 22 publications

(27 citation statements)

References 22 publications

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“…(6) To date, several studies have investigated long-term trauma trends in USA, Japan and UK. (10)(11)(12) The changes in mechanism of injury, mortality and demographics were highlighted in previous studies and particularly a rise in fall injuries and increasing age were among the compelling ndings. (11,12) Moreover, it is now well established that trauma mortality is changing due to demographic alterations and the increasing proportion of elderly trauma patients and their higher mortality.…”

Section: Introductionmentioning

confidence: 84%

“…Ageing of the trauma patient population corroborate with numerous previous trauma studies worldwide. (10)(11)(12) In a previous study from AUH-TC, the median age of all trauma patients increased from 29 to 32 in the timeframe from 2000-2008. (20) These results suggest an accelerated aging of the trauma patient population in Central Denmark Region.…”

Section: Changing Demographicsmentioning

confidence: 94%

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Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Trier¹,

Fjølner

Raaber

et al. 2021

Preprint

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Background: Trauma causes a considerable economic and societal burden and the trauma patient population and its prognosis changes over time. The aim of this study is to analyze ten-year trends of trauma patients at a major trauma center in Denmark. Methods: 5366 patients aged ≥ 16 years with Injury Severity Score (ISS) > 0 admitted by trauma team activation at Aarhus University Hospital Trauma Center between January 1, 2010 and December 31, 2019 were included. Descriptive statistics, incidence rate calculation, parametric and non-parametric test were used. An annual percent change with 95% confidence interval was used to estimate trend in mechanism of injuries. Multiple logistic regression with mortality as outcome were adjusted for age, sex and ISS. Results: The median age increased from 37 in 2010 to 49 in 2019 and the proportion of patients aged ≥ 65 doubled. The incidence of minor injuries (ISS 1-15) decreased from 181.3/105 inhabitants in 2010 to 112.7/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 0.62 (95% CI: 0.54 to 0.72). Severe injuries (ISS > 15) increased from 10.1/105 inhabitants in 2010 to 13.6/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 1.35 (95% CI: 1.04 to 1.76). The proportion of patients with ISS > 15 increased from 18.1% in 2010 to 31.1% in 2019. Multivariable logistic regression showed lower 30-day mortality for all trauma patients with ISS > 0 over the study period when adjusting for age, sex and ISS (Odds ratio: 0.94, 95% CI: 0.90 to 0.99). The 30-day mortality for severely injured patients with ISS > 15 decreased during the study period when adjusting for age, sex and ISS (Odds ratio: 0.92, 95% CI: 0.87 to 0.97). Fall injuries increased with an annual percent change of 4.1% (95% CI: 2.3% to 6.1%). Conclusions: Ten-year trends of trauma patients in Central Denmark Region show an increasing median age, injury severity and number of fall injuries. The 30-day mortality of trauma patients decreased for both minor injuries and severe injuries when adjusting for age, sex and injury severity. Trial registration: Not applicable.

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Section: Introductionmentioning

confidence: 84%

Section: Changing Demographicsmentioning

confidence: 94%

Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Trier¹,

Fjølner

Raaber

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The comparison with other studies on patterns of trauma was limited by the differences in population samples, methods of data collection, number of hospitals involved in the analyses and timeframes taken into account. However, the review of recent literature [10][11][12][13][14][15][16] provided interesting elements of analysis. The incidence of injuries following road traffic collisions has been increasing globally in the last two decades [10], with the exception of countries with high socio-demographic index (i.e.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of trauma admissions in a level 1 trauma center in Northern Italy: a nine-year study

et al. 2021

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The aim of this study was to analyze the results of 9 years of trauma care and data collection in a level 1 urban trauma center in Northern Italy. Overall, 6065 patients have been included in the study; the number of patients managed yearly has doubled between 2011 and 2019. This rise mostly involved patients with injury severity score (ISS) < 16. Most injuries (94%) were blunt. Road traffic accidents, especially involving motorcycles, were the most common cause of injury. Self-inflicted injuries were responsible for less than 5% of trauma but they were severe in 56% of cases. The median age was 38 and it remained constant over the years; 43% of patients had 14–39 years of age. Different characteristics and patterns of injury were observed for each age group and gender. Males were more likely to be injured in the central years of life while females presented a trimodal pattern in the age distribution. Young adults (14–39 years old) were overall at higher risk of self-harm. Overall mortality was equal to 5.2%. Most deceased were male and ≥ 65 years of age.

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“…Falls captured in trauma registries differ from typical methods used in other observational studies that use self-reports through diary or interview. Trauma registries capture more severe falls that result in presentations for medical care with detailed outcome measures such as the severity and site of injury [9, 10]. In contrast, studies relying on self-reported outcomes pick up minor and non-injurious falls.…”

Section: Introductionmentioning

confidence: 99%

Post-stroke patients with moderate function have the greatest risk of falls: a National Cohort Study

et al. 2019

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BackgroundStroke patients have increased risks of falls. We examined national registry data to evaluate the association between post-stroke functional level and the risk of low falls among post-stroke patients.MethodsThis retrospective cohort study analyzed data from national registries to examine the risk factors for post-stroke falls. Data for patients who suffered ischemic strokes and survived the index hospital admission was obtained from the Singapore National Stroke Registry and matched to the National Trauma Registry, from 2011 to 2015. The primary outcome measure was a low fall (fall height ≤ 0.5 m). Competing risk analysis was performed to examine the association between functional level (by modified Rankin score [mRS] at discharge) and the risk of subsequent low falls.ResultsIn all, 2255 patients who suffered ischemic strokes had recorded mRS. The mean age was 66.6 years and 58.5% were men. By the end of 2015, 54 (2.39%) had a low fall while 93 (4.12%) died.After adjusting for potential confounders, mRS was associated with fall risk with an inverted U-shaped relationship. Compared to patients with a score of zero, the sub-distribution hazard ratio (SHR) increased to a maximum of 3.42 (95%CI:1.21–9.65, p = 0.020) for patients with a score of 2. The SHR then declined to 2.45 (95%CI:0.85–7.12, p = 0.098), 2.86 (95%CI:0.95–8.61, p = 0.062) and 1.93 (95%CI:0.44–8.52, p = 0.38) for patients with scores of 3, 4 and 5 respectively.ConclusionsAn inverted U-shaped relationship between functional status and fall risk was observed. This is consistent with the complex interplay between decreasing mobility (hence decreased opportunity to fall) and increasing susceptibility to falls. Fall prevention intervention could be targeted accordingly.(263 words)

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Ten-year trends in traumatic injury mechanisms and outcomes: A trauma registry analysis

Cited by 22 publications

References 22 publications

Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Epidemiology of trauma admissions in a level 1 trauma center in Northern Italy: a nine-year study

Post-stroke patients with moderate function have the greatest risk of falls: a National Cohort Study

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