The magnitude of major trauma in Oklahoma

Injuries are the third leading cause of death in Oklahoma and the leading cause of death and disability among persons 1-44 years. In 2001, participation in the Oklahoma trauma system became mandatory, and all licensed acute care hospitals were required to submit data to the Oklahoma Trauma Registry (OTR). The objective of this study was to describe the magnitude of major trauma occurring in Oklahoma from 2001-2002.

Data were collected from all licensed acute care hospitals in Oklahoma. Only patients meeting the major trauma criteria were included in the study. Mortality was used as the main outcome measure.

A total of 5760 major trauma patients were reported. The mean age was 38 years (range: 5 days-100 years). Over two-thirds of major trauma cases were male. Blacks had the highest rate of injury (89.5/100,000 population). The leading cause of injury was motor vehicle crashes among persons < 65 years and falls among persons 65 years or older. Overall mortality was 16%; after controlling for age, males were significantly more likely to die than females (O.R 1.3; CI 1.1-1.5). Persons injured by firearms were nearly 5 times more likely to die (CFR=42%) than persons injured by all other causes (CFR=14%) (Odds Ratio 4.5; CI 3.6, 5.5). Excluding deaths in the emergency department (ED), patients were hospitalized an average of 9 days (median: 5 days; range 1-204 days). Over two-thirds (69%) of survivors were discharged home and 14% were discharged to a rehabilitation facility.

There are noted demographic and etiological differences in the burden of major trauma. Understanding these differences may be useful in enhancing existing prevention practices in Oklahoma and for generating new research to lower this burden. The OTR is relatively new and still maturing; hence, further studies will be required to increase understanding of other factors that influence the incidence and outcome of trauma.