Patterns of major trauma admissions to a level 1 trauma centre: A five year database analysis.

ABSTRACT

INTRODUCTION: It is only in recent years that major trauma systems and networks have been operating in the UK. High-quality data is available from the Trauma Audit and Research Network (TARN) database, enabling regional analysis. Our aim was to analyse Trauma Team Activations within the Cheshire and Merseyside major trauma network and discuss the implications of these data on resource allocation, training and trauma prevention. METHODS: A retrospective analysis was performed for all patients requiring Trauma Team Activation (TTA) at a category one adult Major Trauma Centre (MTC) who were submitted to the TARN database from the 1st January 2015 to the 1st January 2020. Data collected included the date and time of arrival, location of injury and Injury Severity Score (ISS) in addition to routine demographic data. Dates of major sporting events and school holidays were obtained. RESULTS: 4811 patients were identified. The median age was 57 years; 65.8 % were male. The mean frequency of TTAs was 18.5 per week. Patterns identified include annual peaks during the summer months, October and December, weekly peaks on Thursdays and Sundays and daily peaks between 1600 and 2359 with 45.0 % of TTAs occurring between these hours. There were 5.9 additional TTAs per week during the Isle of Man TT races. The median ISS increased from 14 to 23 for TT race TTAs and from 14 to 36 for Manx Grand Prix TTAs. Those injured during the TT races were twice as likely to require surgery and those injured during the MGP required five additional days in intensive care. School holidays did not independently affect major trauma volumes. CONCLUSIONS: Major trauma in Cheshire and Merseyside did follow distinct patterns according to calendar month, day and time. Major motorsport increased trauma volumes and severity; school holidays did not. Such analysis could enable Major Trauma Centres to tailor the supply of trauma services to meet a predictable local demand for the benefit of our staff and patients.