Table 5 Epidemiological studies from the UK and Ireland- injuries in the general population
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 |