TY - JOUR PY - 2015// TI - The epidemiology of Scottish trauma: a comparison of pre-hospital and in-hospital deaths, 2000 to 2011 JO - Surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland A1 - Morrison, Jonathan J. A1 - Yapp, Liam Z. A1 - Beattie, Anne A1 - Devlin, Eimar A1 - Samarage, Milan A1 - McCaffer, Craig A1 - Jansen, Jan O. SP - 1 EP - 6 VL - 14 IS - 1 N2 - 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.

Language: en

LA - en SN - 1479-666X UR - http://dx.doi.org/10.1016/j.surge.2015.02.001 ID - ref1 ER -