Epidemiology of adolescent trauma in England: a review of TARN data 2008–2017

Abstract

ObjectivesTrauma contributes significantly to adolescent morbidity and mortality. We aimed to ascertain the epidemiology of adolescent trauma to inform prevention strategies.MethodsData were abstracted from TARN (Trauma Audit Research Network) from English sites over a 10-year period (2008–2017). Adolescents were defined as 10–24 completed years. Descriptive statistical analysis was used in this study.ResultsThere were 40 680 recorded cases of adolescent trauma. The majority were male (77.3%) and aged 16–24 years old (80.5%). There was a 2.6-fold increase during the study time frame (p<0.0001) in the total annual number of cases reported to TARN. To account for increasing hospital participation, the unit trauma cases per hospital per year was used, noting an increasing trend (p=0.048). Road traffic collision (RTC) was the leading cause of adolescent trauma (50.3%). Pedestrians (41.2%) and cyclists (32.6%) were more prevalent in the 10–15 year group, while drivers (22.9%) and passengers (17.8%) predominated in the 16–24 year group. Intentional injury was reported in 20.7% (alleged assault in 17.2% and suspected self-harm in 3.5%). This was more prevalent in the 16–24 year group. The proportion of trauma reported due to violence has increased with stabbings increasing from 6.9% in 2008 to 10.2% in 2017 (p<0.0001). Evidence of alcohol or drug use was recorded in 20.1% of cases. There was an increase in the number treated in major trauma centres (45.7% 2008 vs 63.5% 2017, p<0.0001). Trauma was more likely to occur between 08:00 and 00:00, at weekends and between April and October. Overall mortality rate was 4.1%. Those with a known psychiatric diagnosis had a higher mortality (6.3% vs 4.4%, p<0.001).ConclusionsRTCs and intentional injuries are leading aetiologies. Healthcare professionals and policy-makers need to prioritise national preventative public health measures and early interventions to reduce the incidence of trauma in this vulnerable age group.

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

“…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.…”

“…The age group of young adults (14–39 years old) includes the years of adolescence, between 14 and 20 years of age [ 18 ]. Adolescence is characterized by “reduced self-control, increased risk-taking behaviors and experimentation with alcohol and drugs” [ 16 ]. Roberts et al[ 16 ] observed evidence of alcohol and drugs abuse in 20% adolescent trauma patients.…”

“…Adolescence is characterized by “reduced self-control, increased risk-taking behaviors and experimentation with alcohol and drugs” [ 16 ]. Roberts et al[ 16 ] observed evidence of alcohol and drugs abuse in 20% adolescent trauma patients. Mental illnesses often present in adolescence and may lead to suicidal behaviors and Roberts et al observed that adolescents with pre-existing psychiatric diagnosis suffer injuries with higher ISS [ 16 ].…”

Motor Vehicle Collisions during Adolescence: The Role of Alexithymic Traits and Defense Strategies

“…In this field, motor vehicle collisions (MVCs) represent one of the main causes of death among 14- to 19-year-olds worldwide [ 4 , 5 , 6 ], who constitute the population most at risk even of nonfatal MVCs. Epidemiological studies on adolescents’ road collisions have reported a rate of prevalence of approximately of 50% [ 7 , 8 , 9 ], with important consequences for their psychological and physical well-being [ 10 , 11 , 12 ]. Most studies have shown a higher prevalence of injuries and road accidents among males [ 13 , 14 , 15 , 16 , 17 ], and results concerning females in relation to road accidents are few and inconsistent [ 18 , 19 ].…”

Paediatric major trauma in the setting of the Irish trauma network

“…[12] Of note, Ireland has a significantly lower rate of violent injuries in the 10-15 year group when compared to England and the rates of stabbing were 0.2% in Ireland vs 3% in England. [13] Overall, It was reassuring in our study that despite the prevalence of multiply injured patients and the high rate of operative intervention in this cohort, 94.9% of patients suffering major trauma are discharged home after hospital.…”