Age and the distribution of major injury across a national trauma system.

Autor:	Dixon JR; Newcastle University School of Medicine, Newcastle University, Cookson Building, Newcastle Upon Tyne NE2 4HH, UK., Lecky F; Trauma Audit and Research Network, University of Manchester, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK.; School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK., Bouamra O; Trauma Audit and Research Network, University of Manchester, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK., Dixon P; Department of Trauma and Orthopaedics, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK., Wilson F; Department for Care of the Elderly, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK., Edwards A; Trauma Audit and Research Network, University of Manchester, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK., Eardley W; Department of Trauma and Orthopaedics, James Cook University Hospital, Marton Road Middlesbrough, TS4 3BW, UK.; York Clinical Trials Unit, Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York YO105 DD, UK.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2020 Feb 27; Vol. 49 (2), pp. 218-226.
DOI:	10.1093/ageing/afz151
Abstrakt:	Background: Trauma places a significant burden on healthcare services, and its management impacts greatly on the injured patient. The demographic of major trauma is changing as the population ages, increasingly unveiling gaps in processes of managing older patients. Key to improving patient care is the ability to characterise current patient distribution. Objectives: There is no contemporary evidence available to characterise how age impacts on trauma patient distribution at a national level. Through an analysis of the Trauma Audit Research Network (TARN) database, we describe the nature of Major Trauma in England since the configuration of regional trauma networks, with focus on injury distribution, ultimate treating institution and any transfer in-between. Methods: The TARN database was analysed for all patients presenting from April 2012 to the end of October 2017 in NHS England. Results: About 307,307 patients were included, of which 63.8% presented directly to a non-specialist hospital (trauma unit (TU)). Fall from standing height in older patients, presenting and largely remaining in TUs, dominates the English trauma caseload. Contrary to perception, major trauma patients currently are being cared for in both specialist (major trauma centres (MTCs)) and non-specialist (TU) hospitals. Paediatric trauma accounts for <5% of trauma cases and is focussed on paediatric MTCs. Conclusions: Within adult major trauma patients in England, mechanism of injury is dominated by low level falls, particularly in older people. These patients are predominately cared for in TUs. This work illustrates the reality of current care pathways for major trauma patients in England in the recently configured regional trauma networks. (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society.)
Databáze:	MEDLINE
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