269435 Changing profile of trauma patients in a major trauma system , 2000 2010

Tuesday, October 30, 2012

Alan M. Smith, PhD, MPH , Emergency Medical Services, County of San Diego, San Diego, CA
Joshua Smith, PhD, MPH , Emergency Medical Services, County of San Diego Health and Human Services Agency, San Diego, CA
Leslie Ray, MPH, MPPA, MA , County of San Diego Health and Human Services Agency, Public Health Services, San Diego, CA
Barbara M. Stepanski, MPH , Emergency Medical Services, County of San Diego, San Diego, CA
Alicia Sampson, MPH, CPH , Health & Human Services Agency, Public Health Services, County of San Diego, San Diego, CA
Isabel Corcos, PhD, MPH , County of San Diego, Emergency Medical Services, County of San Diego, San Diego, CA
Background/Purpose The purpose of this study was to examine changes in characteristics of patients treated by a major trauma system over the past decade. Methods Trends on mechanism of injury were examined using a countywide trauma registry. Data were submitted from five adult trauma facilities and one pediatric facility for patients meeting major trauma criteria. Results/Outcomes Over the past ten years, the population based rate of major trauma has remained relatively unchanged. During this time, though, the overall profile of the typical trauma patient has changed dramatically. Whereas motor vehicle crashes previously accounted for the most patients, the motor vehicle injury rate has declined by 38%. At the same time, the rate of trauma from falls has doubled. This has resulted in a dramatic increase in the average patient age. In 2000, 9% of major traumas were 75 years of age or older; in 2010, this percentage increased to 19%. Conclusions There has been a major shift in mechanism of injury for trauma patients over the past ten years. Motor vehicle occupant injuries have declined, possibly due to safer vehicles as well as safer driving behaviors, while falls have increased. This has resulted in a major change in patient age, and consequently greater need for expertise specific to the elderly patient population. Important factors include anticoagulant prescribing practices and changes in triage guidelines over this time period. With the older adult population expected to double over the next twenty years, fall prevention efforts will take on even more importance.

Learning Areas:
Biostatistics, economics
Epidemiology
Provision of health care to the public

Learning Objectives:
Describe the ten-year trends in major trauma mechanisms Discuss how demographic projections will influence future trauma trends

Keywords: Injury, Motor Vehicles

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as the trauma system epidemiologist for over ten years, in which time I have managed the county trauma registry and published multiple reports on the topic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.