Jonathan J Morrison1, Liam Z Yapp2, Anne Beattie3, Eimar Devlin4, Milan Samarage3, Craig McCaffer3, Jan O Jansen5. 1. Academic Unit of Surgery, Glasgow Royal Infirmary, Glasgow, UK; The Academic Department of Military Surgery & Trauma, Royal Centre for Defence Medicine, Birmingham, UK. 2. Royal Infirmary of Edinburgh, Edinburgh, UK. 3. Aberdeen Royal Infirmary, Aberdeen, UK. 4. Wishaw General Hospital, Wishaw, UK. 5. Aberdeen Royal Infirmary, Aberdeen, UK; Health Services Research Unit, University of Aberdeen, UK. Electronic address: jan.jansen@abdn.ac.uk.
Abstract
AIMS: To characterise the temporal trends and urban-rural distribution of fatal injuries in Scotland through the analysis of mortality data collected by the National Records of Scotland. METHODS: The prospectively collected NRS database was queried using ICD-10 codes for all Scottish trauma deaths during the period 2000 to 2011. Patients were divided into pre-hospital and in-hospital groups depending on the location of death. Incidence was plotted against time and linear regression was used to identify temporal trends. RESULTS: A total of 13,100 deaths were analysed. There were 4755 (36.3%) patients in the pre-hospital group with a median age (IQR) of 42 (28-58) years. The predominant cause of pre-hospital death related to vehicular injury (27.8%), which had a decreasing trend over the study period (p = 0.004). In-hospital, patients had a median age of 80 (58-88) years and the majority (67.0%) of deaths occurred following a fall on the level. This trend was shown to increase over the decade of study (p = 0.020). In addition, the incidence of urban incidents remained static, but the rate of rural fatal trauma decreased (p < 0.001). CONCLUSIONS: Around a third of Scottish trauma patients die prior to hospital admission and the predominant mechanism of injury is due to road traffic accidents. This contrasts with in-hospital deaths, which are mainly observed in elderly patients following a fall from standing height. Further research is required to determine the preventability of fatal traumatic injury in Scotland.
AIMS: To characterise the temporal trends and urban-rural distribution of fatal injuries in Scotland through the analysis of mortality data collected by the National Records of Scotland. METHODS: The prospectively collected NRS database was queried using ICD-10 codes for all Scottish trauma deaths during the period 2000 to 2011. Patients were divided into pre-hospital and in-hospital groups depending on the location of death. Incidence was plotted against time and linear regression was used to identify temporal trends. RESULTS: A total of 13,100 deaths were analysed. There were 4755 (36.3%) patients in the pre-hospital group with a median age (IQR) of 42 (28-58) years. The predominant cause of pre-hospital death related to vehicular injury (27.8%), which had a decreasing trend over the study period (p = 0.004). In-hospital, patients had a median age of 80 (58-88) years and the majority (67.0%) of deaths occurred following a fall on the level. This trend was shown to increase over the decade of study (p = 0.020). In addition, the incidence of urban incidents remained static, but the rate of rural fatal trauma decreased (p < 0.001). CONCLUSIONS: Around a third of Scottish traumapatients die prior to hospital admission and the predominant mechanism of injury is due to road traffic accidents. This contrasts with in-hospital deaths, which are mainly observed in elderly patients following a fall from standing height. Further research is required to determine the preventability of fatal traumatic injury in Scotland.
Authors: Ben Beck; Karen Smith; Eric Mercier; Belinda Gabbe; Richard Bassed; Biswadev Mitra; Warwick Teague; Josine Siedenburg; Susan McLellan; Peter Cameron Journal: PLoS One Date: 2019-06-04 Impact factor: 3.240
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