Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Abstract

Background: Trauma causes a considerable economic and societal burden and the trauma patient population and its prognosis changes over time. The aim of this study is to analyze ten-year trends of trauma patients at a major trauma center in Denmark. Methods: 5366 patients aged ≥ 16 years with Injury Severity Score (ISS) > 0 admitted by trauma team activation at Aarhus University Hospital Trauma Center between January 1, 2010 and December 31, 2019 were included. Descriptive statistics, incidence rate calculation, parametric and non-parametric test were used. An annual percent change with 95% confidence interval was used to estimate trend in mechanism of injuries. Multiple logistic regression with mortality as outcome were adjusted for age, sex and ISS. Results: The median age increased from 37 in 2010 to 49 in 2019 and the proportion of patients aged ≥ 65 doubled. The incidence of minor injuries (ISS 1-15) decreased from 181.3/105 inhabitants in 2010 to 112.7/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 0.62 (95% CI: 0.54 to 0.72). Severe injuries (ISS > 15) increased from 10.1/105 inhabitants in 2010 to 13.6/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 1.35 (95% CI: 1.04 to 1.76). The proportion of patients with ISS > 15 increased from 18.1% in 2010 to 31.1% in 2019. Multivariable logistic regression showed lower 30-day mortality for all trauma patients with ISS > 0 over the study period when adjusting for age, sex and ISS (Odds ratio: 0.94, 95% CI: 0.90 to 0.99). The 30-day mortality for severely injured patients with ISS > 15 decreased during the study period when adjusting for age, sex and ISS (Odds ratio: 0.92, 95% CI: 0.87 to 0.97). Fall injuries increased with an annual percent change of 4.1% (95% CI: 2.3% to 6.1%). Conclusions: Ten-year trends of trauma patients in Central Denmark Region show an increasing median age, injury severity and number of fall injuries. The 30-day mortality of trauma patients decreased for both minor injuries and severe injuries when adjusting for age, sex and injury severity. Trial registration: Not applicable.

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“…In two-wheeler accidents motorcycle accidents, bicycle and scooter accidents were observed. The findings are similar to a study in which 26% patients had two-wheeler accidents out of which bicycle accidents were commonest followed by motorcycle injuries 17 .…”

“…The mechanism of injury in the study, fall from height followed by fall at home, pedestrian, assault, gunshot shot and others. The findings were similar in study by Frederik Trier et al, like fall (20.3%) is commonest followed by pedestrian injury (5.5%), violence (5.2%), stabbing (2.9%) and gunshot (0.5%) 17 . Other study in Ethiopia showed that fall down was commonest (23.5%) followed by fighting, (31.8%), machine injury (9.4%), stab injury (3%) and burn (1.1%) 14 .…”

“…The findings were in accordance with a study by Abhilash KP et al in which 56.6% patients discharged in stable condition and 41.2% of patients required admission for surgical intervention or conservative management 15 . In another study by Frederik Trier in Denmark for 9 years, the overall mortality was 8.92% 17 . Several European studies 24,25 and a study from Hong Kong 26 have showed a 30-day mortality of trauma patients varying between 14.9% and 22.4%.…”

“…This type of injuries results in huge financial loss for the person and family. It can cause permanent deformities hence immediate management is essential 17 .…”