Differences in the epidemiology of out-of-hospital and in-hospital trauma deaths

Ben Beck, Karen Smith, Eric Mercier, Belinda Gabbe, Richard Bassed, Biswadev Mitra, Warwick Teague, Josine Siedenburg, Susan McLellan, Peter Cameron

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background Trauma is a leading cause of mortality. Holistic views of trauma systems consider injury as a public health problem that requires efforts in primary, secondary and tertiary prevention. However, the performance of trauma systems is commonly judged on the in-hospital mortality rate. Such a focus misses opportunities to consider all deaths within a population, to understand differences in in-hospital and out-of-hospital trauma deaths and to inform population-level injury prevention efforts. The aim of this study was to provide an epidemiological overview of out-of-hospital and in-hospital trauma deaths in a geographically-defined area over a 10-year period. Methods We performed a population-based review of out-of-hospital and in-hospital trauma deaths over the period of 01 July 2006 to 30 June 2016 in Victoria, Australia, using data from the National Coronial Information System and the Victorian State Trauma Registry. Temporal trends in population-based incidence rates were evaluated. Results Over the study period, there were 11,246 trauma deaths, of which 71% were out-of-hospital deaths. Out-of-hospital trauma deaths commonly resulted from intentional self-harm events (50%) and transport events (35%), while in-hospital trauma deaths commonly resulted from low falls (1 metre) (50%). The incidence of overall trauma deaths did not change over the study period (incidence rate ratio 0.998; 95%CI: 0.991, 1.004; P = 0.56). Conclusions Out-of-hospital deaths accounted for most trauma deaths. Given the notable differences between out-of-hospital and in-hospital trauma deaths, monitoring of all trauma deaths is necessary to inform injury prevention activities and to reduce trauma mortality. The absence of a change in the incidence of both out-of-hospital and in-hospital trauma deaths demonstrates the need for enhanced activities across all aspects of injury prevention.

Original languageEnglish
Article numbere0217158
Number of pages17
JournalPLoS ONE
Volume14
Issue number6
DOIs
Publication statusPublished - 4 Jun 2019

Cite this

@article{b7a25ac75b6846b798d843aedb7e1769,
title = "Differences in the epidemiology of out-of-hospital and in-hospital trauma deaths",
abstract = "Background Trauma is a leading cause of mortality. Holistic views of trauma systems consider injury as a public health problem that requires efforts in primary, secondary and tertiary prevention. However, the performance of trauma systems is commonly judged on the in-hospital mortality rate. Such a focus misses opportunities to consider all deaths within a population, to understand differences in in-hospital and out-of-hospital trauma deaths and to inform population-level injury prevention efforts. The aim of this study was to provide an epidemiological overview of out-of-hospital and in-hospital trauma deaths in a geographically-defined area over a 10-year period. Methods We performed a population-based review of out-of-hospital and in-hospital trauma deaths over the period of 01 July 2006 to 30 June 2016 in Victoria, Australia, using data from the National Coronial Information System and the Victorian State Trauma Registry. Temporal trends in population-based incidence rates were evaluated. Results Over the study period, there were 11,246 trauma deaths, of which 71{\%} were out-of-hospital deaths. Out-of-hospital trauma deaths commonly resulted from intentional self-harm events (50{\%}) and transport events (35{\%}), while in-hospital trauma deaths commonly resulted from low falls (1 metre) (50{\%}). The incidence of overall trauma deaths did not change over the study period (incidence rate ratio 0.998; 95{\%}CI: 0.991, 1.004; P = 0.56). Conclusions Out-of-hospital deaths accounted for most trauma deaths. Given the notable differences between out-of-hospital and in-hospital trauma deaths, monitoring of all trauma deaths is necessary to inform injury prevention activities and to reduce trauma mortality. The absence of a change in the incidence of both out-of-hospital and in-hospital trauma deaths demonstrates the need for enhanced activities across all aspects of injury prevention.",
author = "Ben Beck and Karen Smith and Eric Mercier and Belinda Gabbe and Richard Bassed and Biswadev Mitra and Warwick Teague and Josine Siedenburg and Susan McLellan and Peter Cameron",
year = "2019",
month = "6",
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doi = "10.1371/journal.pone.0217158",
language = "English",
volume = "14",
journal = "PLoS ONE",
issn = "1932-6203",
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Differences in the epidemiology of out-of-hospital and in-hospital trauma deaths. / Beck, Ben; Smith, Karen; Mercier, Eric; Gabbe, Belinda; Bassed, Richard; Mitra, Biswadev; Teague, Warwick; Siedenburg, Josine; McLellan, Susan; Cameron, Peter.

In: PLoS ONE, Vol. 14, No. 6, e0217158, 04.06.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Differences in the epidemiology of out-of-hospital and in-hospital trauma deaths

AU - Beck, Ben

AU - Smith, Karen

AU - Mercier, Eric

AU - Gabbe, Belinda

AU - Bassed, Richard

AU - Mitra, Biswadev

AU - Teague, Warwick

AU - Siedenburg, Josine

AU - McLellan, Susan

AU - Cameron, Peter

PY - 2019/6/4

Y1 - 2019/6/4

N2 - Background Trauma is a leading cause of mortality. Holistic views of trauma systems consider injury as a public health problem that requires efforts in primary, secondary and tertiary prevention. However, the performance of trauma systems is commonly judged on the in-hospital mortality rate. Such a focus misses opportunities to consider all deaths within a population, to understand differences in in-hospital and out-of-hospital trauma deaths and to inform population-level injury prevention efforts. The aim of this study was to provide an epidemiological overview of out-of-hospital and in-hospital trauma deaths in a geographically-defined area over a 10-year period. Methods We performed a population-based review of out-of-hospital and in-hospital trauma deaths over the period of 01 July 2006 to 30 June 2016 in Victoria, Australia, using data from the National Coronial Information System and the Victorian State Trauma Registry. Temporal trends in population-based incidence rates were evaluated. Results Over the study period, there were 11,246 trauma deaths, of which 71% were out-of-hospital deaths. Out-of-hospital trauma deaths commonly resulted from intentional self-harm events (50%) and transport events (35%), while in-hospital trauma deaths commonly resulted from low falls (1 metre) (50%). The incidence of overall trauma deaths did not change over the study period (incidence rate ratio 0.998; 95%CI: 0.991, 1.004; P = 0.56). Conclusions Out-of-hospital deaths accounted for most trauma deaths. Given the notable differences between out-of-hospital and in-hospital trauma deaths, monitoring of all trauma deaths is necessary to inform injury prevention activities and to reduce trauma mortality. The absence of a change in the incidence of both out-of-hospital and in-hospital trauma deaths demonstrates the need for enhanced activities across all aspects of injury prevention.

AB - Background Trauma is a leading cause of mortality. Holistic views of trauma systems consider injury as a public health problem that requires efforts in primary, secondary and tertiary prevention. However, the performance of trauma systems is commonly judged on the in-hospital mortality rate. Such a focus misses opportunities to consider all deaths within a population, to understand differences in in-hospital and out-of-hospital trauma deaths and to inform population-level injury prevention efforts. The aim of this study was to provide an epidemiological overview of out-of-hospital and in-hospital trauma deaths in a geographically-defined area over a 10-year period. Methods We performed a population-based review of out-of-hospital and in-hospital trauma deaths over the period of 01 July 2006 to 30 June 2016 in Victoria, Australia, using data from the National Coronial Information System and the Victorian State Trauma Registry. Temporal trends in population-based incidence rates were evaluated. Results Over the study period, there were 11,246 trauma deaths, of which 71% were out-of-hospital deaths. Out-of-hospital trauma deaths commonly resulted from intentional self-harm events (50%) and transport events (35%), while in-hospital trauma deaths commonly resulted from low falls (1 metre) (50%). The incidence of overall trauma deaths did not change over the study period (incidence rate ratio 0.998; 95%CI: 0.991, 1.004; P = 0.56). Conclusions Out-of-hospital deaths accounted for most trauma deaths. Given the notable differences between out-of-hospital and in-hospital trauma deaths, monitoring of all trauma deaths is necessary to inform injury prevention activities and to reduce trauma mortality. The absence of a change in the incidence of both out-of-hospital and in-hospital trauma deaths demonstrates the need for enhanced activities across all aspects of injury prevention.

UR - http://www.scopus.com/inward/record.url?scp=85066619269&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0217158

DO - 10.1371/journal.pone.0217158

M3 - Article

VL - 14

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 6

M1 - e0217158

ER -