Abstract text (incl. references and figure legends)
Introduction
With an increasingly elderly major trauma population in the UK, lower energy transfer injuries are increasingly common, and understanding recent trends can help to guide trauma prevention resources.
Materials and Methods
Data were collected prospectively from 2012 to mid-2022 at a tertiary level UK major trauma centre and used to calculate the number and proportion of admissions by injury mechanism, as well as the case fatality rates. These were split up into falls under 2m, falls over 2m, vehicle collisions, shooting, stabbing, blast, blow, burn, crush and other injuries. Trends were calculated using linear regression models, and comparisons between annual mortality rates were made using a one-way ANOVA with post-hoc Tukey test.
Results:
There were 8894 major trauma admissions from 2012-2022, leading to 595 deaths. The most common mechanisms were falls under 2m, vehicle collisions and falls over 2m, making up 38.1%, 24.0% and 22.5% of admissions respectively. Falls under 2m caused the largest proportion of deaths (40.5%), followed by falls over 2m (28.2%) and vehicle collisions (18.5%), with significantly higher annual case fatality rates in the falls over 2m than the vehicle collisions group (p=0.005). Total and injury specific case fatality rates did not significantly change over the time period, with 7% mortality in falls under 2m, 8.3% in falls over 2m, 5.1% in vehicle collisions and 4.7% in stabbings. Between 2012 and 2021, total annual admissions nearly tripled from 404 to 1135 (p<0.0001), as did annual deaths from 28 to 72 (p=0.0003). The proportion of admissions from falls under 2m increased from 39.6% to 47.8% (p=0.02), blow injuries decreased from 16.8% to 7.6% (p= 0.003), while other mechanisms did not significantly change.
Conclusion:
Falls from under 2m are causing an increasingly large burden of major trauma admissions and deaths. These results can help to address this by influencing civic and regional trauma prevention schemes.
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