Background
Lexicon | Injury description | Code3
|
---|---|---|
ICD-9 | Abdominal Aorta Injury | 902.0 |
ICD-10 | Injury of abdominal aorta | S35.0 |
AIS90 | Aorta, Abdominal NFS (not further specified) | 520299.4
|
intimal tear, no disruption | 520202.4
| |
laceration (perforation, puncture) NFS | 520204.4
| |
minor1
| 520206.4
| |
major2
| 520208.5
|
Methods
Results
UK and Ireland
Author and date | Type of study/data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
---|---|---|---|---|---|---|
Walsh et al., 1996 [50] | descriptive (prospective) study/Coroner's files; Hospital data | children (0–16 y)/54400 Newcastle upon Tyne, England | deaths, hospitalization and A&E | proportions, rates by severity (ISS), type, cause; correlation A&E rates and Townsend score | 1990 6 deaths: 904 admissions: 11682 A&E (1660/21490 per 100,000 admission/attendance rate); some associations of hospitalisations and A&E with deprivation | 1 year study and one geographical region. |
Walsh & Jarvis, 1992 [55] | descriptive (retrospective) study/Office for Population Censuses Surveys; Northern Regional Health Authority | sample children (0–16 y)/153000 Northern Region England | deaths, hospitalization | proportions by type, cause; rates by severity (ISS), age, ward; correlation of rates by census ward, severity | 1980–1986 Relationship of injury admission rates, deaths and severity with deprivation, e.g. relative rate of deprived vs. affluent areas 2.4 (all injuries); 3.6 (severe injuries) Highlights of the value of ISS methodology in epidemiological analysis | 96.4% of the hospitals admissions identified. |
Armstrong & Robson, 1992 [47] | descriptive study/Liverpool Coroner's Office data | children (0–16 y) Liverpool, England | deaths | proportions by cause, circumstances | Highlights areas of prevention: 60% pedestrian RTC (1978–1987) – half pedestrians struck by vehicles | No population based rates; data on deaths only; one region |
Hippisley-Cox et al., 2002 [56] | cross sectional survey/Trent NHS regional admissions database | children (0–14 y) Trent Region, England | hospitalization | proportions by cause, age; rates by age, severity and deprivation; rate ratios for hospitals admissions | 1992–1997 socioeconomic gradients (particularly children under 5 y); adjusted rate ratio (fifth highest and lowest category by Townsend scores): 3.65 pedestrian; 3.49 burns & scalds | Data on severity based on health services use; one geographical region only |
Laing & Logan, 1999 [53] | descriptive study/A&E King's College, St Thomas's, Guy's hospitals registries | children (0–14 y) South-East London, England | A&E | proportions and rates by age, gender, severity; correlation of Townsend score with A&E rates | 1992/1993 13820/100,000 annual attendance rate; socioeconomic gradients (even) within a disadvantaged population: a significant correlation between Townsend score and A&E attendance rate (p < 0.001) | 1 year study; 4 arbitrary categories of injury severity; codification – Home &Leisure Accident Surveillance |
Edwards et al., 2008 [51] | descriptive study/Hospital Episodes Statistics | children (0–15 y) England | hospitalization | rates and proportions by cause, rate ratio by socio-economic classes, location, index of multiple deprivation, regression (injury rates- census variables) | 1999–2004 1340/100,000 all injury rates 15.8/100,000 serious injury rate; falls account for 36% and 41% of all/serious admissions; socio-economic gradients for serious injuries, e.g. RR = 4.1 pedestrian i and RR = 3.0 cyclists most vs. least deprived areas | Serious injury defined by six ICD groups (S72.0, S06.1–.9, S14, S22.4, T71, T68) |
Avery et al., 1990 [40] | descriptive study/Office for Population Censuses Surveys | children (0–14 y) England and Wales | deaths | rates by geographical areas, trends and correlation of deprivation with deaths rates | 1975/1979 12.05/100,000; 1980/1984 10.33/100,000 geographical variations (higher urban vs. rural areas, NW vs. SE England); 1980–1984 socioeconomic gradients r = 0.56 for accidental deaths rate | Data on deaths only |
Author and date | Type of study/data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
---|---|---|---|---|---|---|
Roberts et al., 1996 [46] | descriptive study/Office for Population Censuses Surveys | children (0–15 y) England and Wales | deaths | rates by social class and cause; trends of mortality rates | 1979–83 to 1989–92 Social class gradients in mortality: 21% and 2% decline in social classes IV and V (47.5 to 37.8/100,000 and 84.7 to 82.9/100,000); 32% and 37% decline in social classes I and II (24.2 to 16.5/100,000 and 25.0 to 15.8/100,000) | Data on death only; missing data for 1981 |
DiGuiseppi et al., 1997 [43] | descriptive study/Office for National Statistics | children (0–14 y) England and Wales | deaths | proportions and trends of rates per mile travelled by age, gender, type road user | Travel patterns responsible for (34%) decline in children rates 1985–1992; declines in walking/cycling activities (37% and 38% declines pedestrian/cyclist rates) | Data on deaths only, focused on road traffic injuries; no population based rates for all injuries |
Edwards et al., 2006 [41] | descriptive study/Office for National Statistics | children (0–15 y) England and Wales | deaths | rates and proportions by socio-economic classes, year, 3 y average, cause | 1979–2003 Decline in death rates (per 100,000) from 11.1 (1979,1980, 1982) to 4.0 (2001–2003). Socio-economic gradients e.g. 13.1 times higher all external causes injury rates NSSEC* class 8 vs.1 | Data on deaths only; lack of 1980 injury deaths data |
Lyons et al., 1995 [57] | descriptive study/West Glamorgan injury database | children (0–14 y)/370000 West Glamorgan County, Wales | A&E | proportions by place; rates and correlation of distance to A&E, no car and Townsend with rate ratio | 1993 18200 injuries/100,000 Association of overall and home injury with proximity to A&E unit; no association of injury with socioeconomic status | Fractures as a proxy indicator for severe injuries – Nuffield Hospital Classification 1 year study |
Graham et al., 2004 [52] | descriptive (prospective) study/Crosshouse Hospital questionnaire data; Procurator Fiscal | children (0–13 y)/10697 Kilmarnock, Scotland | deaths, hospitalization and A&E | proportions by type; rates of admissions by age | 1999/2000 5.6 hospital admissions per day Information on local injury data and preventive measures in use (cycle helmets used in 26% of cycle incidents; adult supervision in 49% of incidents) | No population based rates, no information on severity; 12.9% response rate |
MacInnes & Stone 2008 [54] | descriptive study/Royal Hospital Sick Children database | children (<7 y) Glasgow, Scotland | A&E | proportions by age, gender, location, circumstances, cause, type of injury; rates by age, gender, location | 1997–2001 14400/100,000 per year A&E attendance rate, peak values within 12–35 months; leading causes and types: 41% falls; 68% home location; 62% play related; 52% head injuries. | No information on severity; one geographical region only |
Ness et al., 2002 [58] | descriptive survey/Glasgow Royal Infirmary Questionnaire data | children (13 y)/1493 Glasgow, Scotland | A&E | proportions by age, postcode – deprivation (Carstair Depcat) | 1990 injuries by type, location (facial laceration, radius/ulna fractures most frequently; 72% outside house); most of injured children come from highest area of deprivation | 53%questionnaire response rate; selection 10% of the questionnaires for analysis; study period – 3 months |
Author and date | Type of study/data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
---|---|---|---|---|---|---|
Roberts et al., 1998 [42] | analytical study/Office for National Statistics | children and teenagers (0–19y) England and Wales | deaths | proportions by age, gender, type, cause, trends; rates by socio-economic classes, RR (manual/non-manual), correlation homicide and deaths of undetermined intent | 1980–1995 declining trends for unintentional injury (16 to 7/100,000) and no declining trends for intentional injury (2/100,000); socioeconomic gradients (e.g. homicide rate social class V is 17 times higher than for children social class I) | Data on deaths only |
Roberts et al., 1998 [48] | descriptive study/Office for National Statistics; NHS data | children and teenagers (0–19y) England and Wales | deaths, hospitalization | proportions, rates by age and cause, trends of mortality rates and costs | 1992 8.6 deaths/100,000 (unintentional injuries); 1.2 deaths/100,000 (intentional) Socioeconomic gradients, declining trends for unintentional injury 1980–1995 | Few data on morbidity – no population based rates |
DiGuiseppi et al., 1998 [44] | descriptive study/Office for National Statistics | teenagers (15–19y) England and Wales | deaths | proportions and trends of rates per mile travelled by gender, type road user | Travel patterns responsible for (32%) decline in teenage rates 1985–1995; declines in motorcycling (12.1 to 2.5 boys; 1.4 to 0.0 girls), walking (3.2 to 2.1 boys; 1.8 to 0.6 girls) and cycling activities (1.7 to 1.1 boys; 0.4 to 0.1 girls) rates per 100,000 | Data on deaths only, focused on road traffic injuries; no population based rates for all injuries |
Roberts et al., 1996 [45] | analytic study Major Trauma Outcome Study | patients (0–24y)/3320 England, Wales, Northern Ireland | deaths, hospitalization | proportions by cause, type, severity (ISS ≥ 16), case fatality, trends in odds of death | 1989–1995 16% decline per year of odds of deaths; case fatality (ISS ≥ 16) 50 to 8.8% 0–4y; 29.5 to 16.2% 5–14y; 29.7 to 20.4% 15–24y.; role of hospital care in the reduction of trauma mortality in young people | Data on blunt trauma only; no population based rates; analysis focused on mortality (ISS ≥ 16); pre-hospital deaths not available |
Author and date | Type of study/data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
---|---|---|---|---|---|---|
Gorman et al., 1999 [61] | descriptive study/St John's hospital A&E data | general population/44224 (residents EH45) Livingston, England | A&E | proportions by age, gender, type and location of injury; rates by age, gender, deprivation (Carstairs Depcat), eye injury data by location and type | 1995–1996 19620/100,000 attendance rate Evidence of injury association with deprivation: 20910/100,000 vs. 16630/100,000 most deprived vs. most affluent Depcat and travel distance: 21480/100,000 i.e. highest attendance rate in the Depcat 4 were the hospital is located | No information on severity of injury; one geographical region |
Cryer et al., 1996 [59] | descriptive study/Office for Population Censuses Surveys; South East Thames Regional Health Authority hospital data | general population/3.67 million Kent, East Sussex, South East London, England | deaths, hospitalization | proportions of deaths by injury location; rates by age, gender, cause, ICD code | A comprehensive picture (1988–1991) on the epidemiology of injury, priority setting 35/100,000 crude death rate/1057.5/100,000 hospitalisation rate; admissions by nature of injury: fracture limb 27%, poisoning 14%, intracranial injury 11% | No information on severity; one geographical region |
Gorman et al., 1995 [64] | descriptive study/Coroner's data; Home Office data; A&E, ITU, theatre registers | general population/3.2 million Mersey Region and North Wales, UK | deaths, hospitalization and A&E | proportions and rates by age, cause, ISS, injury parameters (e.g., GCS, systolic blood pressure), hospital, outcome (died/alive) | A Level I Trauma Centre (American-style) might be not sustained by blunt injury incidence (ISS>15) in region i.e. 19/100,000 for patients arriving alive at hospital 1989/1990 | Only injuries ISS >15 |
Lecky et al., 2000 [65] | descriptive study/TARN | patients/91602 England, Wales, Northern Ireland | deaths, hospitalization | proportions by cause, process of care (prehospital timing), trends in odds of deaths, Ws*, regression (odds of deaths – Revised Trauma Score, ISS) | 6% statistical significant gradual decline in case mix adjusted odds of deaths 1989–1997 RTC 36.3%, falls 46.5% | Trauma registry not whole population used as denominator; non-thermal blunt trauma; pre-hospital deaths not available |
Lecky et al., 2002 [66] | descriptive study/TARN | patients/129979 England, Wales, Northern Ireland | deaths, hospitalization | proportions by age, gender, ISS, process of care (seniority of doctors), trends in odds of deaths, Ws*, regression (odds of deaths – Revised Trauma Score, ISS) | No significant change in case mix adjusted odds of death 1994–2000 (p = 0.35) 6.2% death outcome | Trauma registry not whole population as denominator; non-thermal blunt trauma pre-hospital deaths not available |
Author and date | Type of study/data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
---|---|---|---|---|---|---|
Lyons et al., 2003 [60] | descriptive study/Patient Episode Database for Wales | general population/2.84 million Wales | hospitalization | proportions by age, type, cause; crude and world standardised rates by age, cause, deprivation category (Townsend score), hospitalisation ratios | 1997–1999 1493/100,000 (world) standard admission rate; socioeconomic gradients in children and older people for pedestrian assault related injuries | No information on severity of injury |
McKee et al., 1990 [62] | descriptive study/Hospital A&E data | sample of general population – one rural area Northern Ireland | A&E | rates; regression (A&E attendance – distance travelled, socio-economic variables) | 1986 22000/100,000 attendance rate association of injury with travel distance to A&E (r = -0.73); no association with deprivation or practice characteristics | Extrapolation of results less likely, one geographical region |
McNicholl & Cooke, 1995 [63] | descriptive study/Northern Ireland hospitals records | general population/1 million Northern Ireland | hospitalization | proportions and rates by age, gender, cause, diagnosis, process of care (surgical procedures), outcome (death, persistent vegetative state, severe/moderate disability, good recovery) | 1990/1991 23.2/100,000 incidence rate overall/20.5/100,000 excluding terrorist activities (injuries ISS >15) | 1 year only study, only injuries ISS>15 (excludes pre-hospital deaths) |
Boland et al., 2005 [68] | descriptive study/Central Office Statistics; Hospital In Patient Enquire data | general population Republic of Ireland | deaths, hospitalization | proportions, standardised mortality and admission ratios by cause, age, gender, urban vs. rural | 1980–2000/1993–2000 unintentional injuries Standardized mortality/admission ratios (rural) 103.0/104.6 | No information on severity |
Scallan et al., 2004 [67] | descriptive study/Central Statistics Office; Hospital In Patient Enquire | general population Ireland | deaths, hospitalization | proportions and rates by cause, type | Highlights the importance of using morbidity (1993–1997, 1239.9/100,000) & mortality (1980–1996, 31.6/100,000) data on a complementary way; 1:39 deaths: hospital admissions ratio | Morbidity and mortality data cover different time periods; unintentional injuries |
Europe
Author and date | Type of study/ data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
---|---|---|---|---|---|---|
Brudvik., 2000 [76] | descriptive study/Haukeland University Discharge Register | children<16y/227250 Bergen Norway | hospitalization and A&E | proportions by gender, body region, cause, circumstances of injury; rates by age, cause | 1998 Annual injury incidence 9% preschool children/13% school children head injury (51%) in preschool children upper extremity injury (46%) in school children 63% of injuries occurs outdoors | No information on severity; 1 year study and one geographical region only |
Mattila et al., 2005 [69] | descriptive study/Finnish Official Cause of Death Statistics | adolescents (10–19y)/0.8 million (1971) - 0.6 million (2002) Finland | deaths | proportions and rates by age, gender, year, trends of mortality rates | 1971–2002 decline in death rates from 43.0 to 19.9 per 100,000; decline in RTC; no changes in intentional deaths | Data on deaths only |
Parkkari et al., 2000 [71] | descriptive study/Finnish Official Cause of Death Statistics; National Hospital Discharge Register | children (0–14y)/1.1 million (1971) - 0.9 million (1995) Finland | deaths, hospitalization | rates and proportions by age, gender, cause type, year; trends of incidence and mortality rates | 1971–1995 decline of incidence fatal injury rates (per 100,000): 20.1 to 4.6 (girls)/36.7 to 9.3 (boys); 1995 causes of deaths: 41% RTC, 24% intentional injuries, 12% drowning; little change non-fatal injuries rates | No information on severity; serious injuries defined by those requiring hospitalisation |
Stefansdottir & Mogensen, 1997 [70] | descriptive (retrospective) study/Reykjavik City Hospital data | children (0–14y)/20756 Reykjavik, Iceland | deaths, hospitalization and A&E | proportions by age; rates by age, gender and trends of incidence rates | 1974–1991 Total incidence rate 760 per 100,000/year 1987–1991 Mortality rate 6.5 per 100,000/year | No information on severity; one geographical region only |
van der Voorde et al., 2008 [72] | descriptive study/PaEdiatric Network around Trauma | children (0–17y)/1.2 million Flanders, Belgium | deaths, hospitalization and A&E | proportions by age, gender, cause, severity (ISS), type, body region, location and injury circumstances, process of care (e.g., waiting time); rates by cause | 2005 11900/100,000 all A&E injury rate; 1150/100,000 A&E traffic accidents rate 84.3% blunt injuries, 40.6% home injuries, 53.8% sport injuries 37.3% of all injuries have ISS>8 | No population based rates of major trauma (ISS>15), 'severe trauma' defined by length of hospital stay>48 hours, including all non-survivors, 1 year study, and one geographical region only; analysis based on 21.9% sample |
Author and date | Type of study/data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
---|---|---|---|---|---|---|
Borzecky et al., 2002 [77] | descriptive study/Surgical Ward of Specialist Paediatric Hospital Kielce data | children (7–15 y) Kielce, Poland | hospitalization | proportions by age, gender, cause, location, urban/rural, time of occurrence | 1997/1998 46% of injuries within age 10–12 y; most of injuries occurs in boys; leading locations: 56% at home; 18% on the road; 13% at school, 7% at farms; 53% rural area | No population based rates, no information on severity; 1 year study and one geographical region only |
Oprescu et al., 2008 [73] | analytic study/Children Clinical Hospital data | children (0–18 y)/Cluj Napoca, Romania | A&E | proportions by age, gender, type, cause, ethnic status, location, process of care (e.g. waiting time), OR (injury type/age, gender, location); rates by age | 1999–2003 A&E attendance rate per 100,000: 197 (age <5 y)/140 (age 5–14 y)/135 (age 15–18 y) 77.8% unintentional injuries,; 55.8% home injuries (unintentional); higher risk of injuries for boys vs. girls; falls as a leading cause age 0–14 y | No information on severity; one geographical region only; non-fatal injuries |
Petridou et al., 2001 [75] | analytic study/Emergency Department Injury Surveillance System | children (0–14 y) Athens, Magnesia, Island of Corfu Greece | A&E | proportions by age, gender, type, circumstances of injury, process of care (e.g. treatment), rates and regression (OR intentional vs. non-intentional -socio-demographic variables, injury details) | 1996–1997 108 injuries out of 46.807 due to violence; rates per 100,000 (violence): 18 (Athens)/21 (Magnesia)/31 (Corfu) subgroup at higher risk: boys/age 10–14 y/migrants, OR = 1.3/2.7/3.6 | No population based rates for un-intentional injuries |
Petridou et al., 2005 [74] | analytic (prospective) study/Health care outlets and educational institutions; police records; hospital data | children (0–14 y)/784 Velestino town, Greece | hospitalization, A&E and other sources – police, health care outlets) | proportions, rates by severity (ISS), age, gender; OR, regression (OR injury – socio-demographic and somatometric variables) | 1994/1995 28.2 per 100 person year overall incidence rate; 6.3 per 100 person year incidence rate (ISS>4) subgroup at higher risk: children with younger parents/low level of education, OR = 1.33/1.37 | 1 year study and one geographical region only |
Author and date | Type of study/ data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
---|---|---|---|---|---|---|
van der Sluis et al., 1996 [85] | descriptive study/University Hospital Groningen data | youth (20–29 y) and elderly (>60 y) Groningen, The Netherlands | hospitalization | proportions by severity (ISS), age, gender, cause, body region, process of care (e.g. length of stay), outcome (disability, died, vegetative state) | 1985–1990 (injuries ISS ≥ 16) RTC leading cause 76.6 vs. 79.3% young vs. elderly; 19.6 vs. 38.8% mortality in young vs. elderly patients 100% mortality in elderly with ISS ≥ 50 | No population based rates; only injuries ISS ≥ 16 |
van Beeck et al., 1998 [84] | descriptive study/Road Traffic Accident Registry; Occupational Registry; National Medical Registry; Dutch Central Bureau of Statistics | general population The Netherlands | deaths, hospitalization and A&E | proportions and rates by cause, location, trends of crude/standardized mortality, incidence and case-fatality rates, exposure/injury risk | 1950–1995 (several data sources) Mortality upward trend (1950–1970), downward trend until mid 80s then diminishes; all changes reflecting trends in incidence and case-fatality rates. Role of trauma care, preventive measures, economic & autonomous factors (cultural, demographical and technological trends) | Injury severity defined by case fatality within broad classes, e.g. intracranial injuries; internal injuries organs in the chest |
Kannus et al., 2001 [88] | descriptive study/National Hospital Discharge Register | adults (>15 y)/5 million Finland | hospitalization | proportions and rates crude/standardized by gender, cause, mechanism, trends of incidence rates | Changes in the profile of injury (1971–1995) with falls as the leading cause for both men and women 1995 falls age adjusted incidence rate male/female 635/689 per 100,000 | No information on severity; serious injuries defined by those requiring hospitalisation |
Kannus et al., 2005 [87] | descriptive study/Finnish Official Cause of Death Statistics | adults (>15 y)/3.5 million (1971) 4.3 million (2003) Finland | deaths | rates crude/standardized by age, gender, cause, trends of mortality rates | Changes in the unintentional injury deaths (1971–2003) with falls replacing RTC as the leading cause 1971–2003 falls age adjusted death rate male/female 18–24/30-18 per 100,000 | Data on deaths only; unintentional injuries |
Sahlin et al., 1990 [81] | descriptive study/Trondheim hospital records and questionnaire data; general practice data | general population Trondheim, Norway | hospitalization general practitioners visits | proportions by severity (AIS code, 1976), body region, location; rates by age, gender, type | 1985/1986 incidence rate 11400 per 100,000 persons; 0.4% of all injury – fatal; 9% of all injury – hospitalised Home accidents leading cause for injuries (39%) followed by RTC (15%) RTC leading cause for fatal accidents (42%) | 1 year study and one geographical region only |
Author and date | Type of study/data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
---|---|---|---|---|---|---|
Ekman et al., 2007 [79] | descriptive study/National Statistical Offices; WHO database | general population/98150 Sweden (Boras); 65841 Latvia (Jelgava); 378913 Lithuania (Kaunas); 101140 Estonia (Tartu) Sweden, Baltic States | deaths | rates by gender, crude and standardized, yearly, 3 y average; trends of mortality rates | 1990–2002 mortality rates per 100,000: 38 (Boras)/101 (Tartu)/112 (Jelgava)/126 (Kaunas); stable trends in Sweden, increasing rates until 1994, seamed to stabilized after 1997 in Baltic communities; higher rates in males vs. females and in age group under 65 y old in the Baltic communities than in Boras, Sweden. | Data on death only |
Buschmann et al., 2008 [86] | descriptive study/German trauma registry | general population (0–55 y) Germany | deaths, hospitalization and A&E | proportions by age, gender, body region, cause, process of care (e.g., length of stay) outcome (died/alive) | 1997–2003 children 3% of all patients multiple injured 0–15 y: 61% boys vs. 39% girls; over 70% head injuries 0–55 y: 41.3% RTC, 59.5% thorax injuries | No population based rates, only injuries ISS>16; data focused on children |
Tiret et al., 1989 [83] | descriptive study/Hospitals data; deaths certificates | general population/2.7 million Aquitaine, France | deaths, hospitalization | proportions by severity (ISS), cause, type, outcome (eight days still hospitalised/died in hospital); rates by age, gender, cause; non-fatal/fatal rate ratio | 1985/1986 136/10,000 all injury incidence rate; 40% falls, 27% traffic accidents, 15% poisonings Origin: suicide 14%, assault or homicide 3%, 82% others | 1 year study and one administrative region only |
Di Bartolomeo et al., 2004 [78] | descriptive (prospective)study/Friuli Venezia Giulia regional registry | general population/1.2 million Friuli Venezia Giulia Italy | deaths, hospitalization | proportions by age, gender, cause, severity (ISS), process of care (e.g., timing), outcome (died/alive), rates by severity | 1998/1999 238 per mil per year mortality rate; 522 per mil per year incidence rate for severe injuries (ISS>15 & pre-hospital deaths); 98.2% blunt injury 81% RTC, 9.1% falls | Only injuries ISS >15; 1 year study and one geographical region only (excludes self inflicted injuries) |
Plasencia & Borell 1996 [82] | cross sectional survey/A&E Hospitals questionnaire data; City Death Registry | adults (>14 y)/1.7 million Barcelona; 6 million Catalonia, Spain | deaths, hospitalization and A&E | proportions by age, gender, cause, severity (ISS), type, location; rates age, gender, cause, location; case admission ratio | 1990/1991 7470/100,000 all injury rate 1.4 times higher rates in males vs. females, falls as a leading cause; 56/100,000 mortality rate 2 times higher in males vs. females; traffic injuries as leading cause; 4% of all injuries have ISS>8; 1 death:6 admissions:133 A&E | No population based rates of major trauma (ISS>15, 1 year study, and one geographical region only; analysis based on extrapolated data on injuries |
Petridou et al., 2004 [80] | descriptive study/Questionnaire data; A&E Injury Surveillance System | adults (>15 y) Greece | hospitalisation, A&E | proportions by age, gender, type; rates by gender, event timing (injury in relation to the interview date) | 2001 5.9 per 100 person-year incidence reported within a survey vs. 12.9 per 100 person-year incidence reported from the surveillance system | Major injuries defined as those requiring health care; 1 y study |
Discussion
Data sources
The epidemiological profile
Author and date | Population size (million) | Place/time period | Adjust. for age | Inclusion of pre-hospital deaths | Description of the numerator | Rate (100,000 per year) |
---|---|---|---|---|---|---|
Walsh et al. 1996 [50] | 0.05* | Newcastle upon Tyne, UK/1990 | N | Y | Injuries ISS>8 | 430 |
Petridou et al.2005 [74] | 0.001** | Velestino, Greece/1994–1995 | N | Y | Injuries ISS>4 | 6300 |
Gorman et al. 1995 [64] | 3.2 | Mersey Region and North Wales, UK/1989–1990 | N | N | Blunt injuries ISS>15 | 19.0 |
McNicholl & Cooke 1995 [63] | 1.5 | Northern Ireland/1990–1991 | N | N | Injuries ISS>15 | 23.2 |
Di Bartolomeo et al. 2004 [78] | 1.2 | Friuli Venezia Giulia, Italy/1998–1999 | N | Y | Injuries ISS>15 | 52.2 |
Demetriades et al. 1998 [92] | 9.4 | Los Angeles, USA/1996 | Y | Y | All trauma cases in the registry | 151.0 |
Potenza et al. 2004 [91] | 2.6 | San Diego, USA/1987–1997 | Y | Y | All trauma cases in the registry | 195.0 |
Karmali et al. 2005 [93] | > 1*** | Calgary, Canada/1999–2002 | N | Y | Injuries ISS>12 | 71.5 |
Cameron et al. 1995 [101] | 4.2 | Victoria, Australia/1992–1993 | N | N | Injuries ISS>15 | 25.6 |