Trauma recidivism in England and Wales: an epidemiological study

Area of Science:

• Geriatric Trauma
• Public Health Surveillance
• Injury Prevention

Background:

• Trauma recidivism, defined as repeated injuries in the same patient, lacks prior evaluation in England and Wales.
• Existing research on trauma recidivism demographics and mechanisms may not apply due to regional differences.
• This study investigates the specific characteristics and outcomes of patients experiencing recurrent trauma in England and Wales.

Purpose of the Study:

• To determine the demographic characteristics of patients with recurrent trauma.
• To identify the primary injury mechanisms leading to trauma recidivism.
• To analyze the outcomes associated with repeated trauma admissions.

Main Methods:

• A national, retrospective, population-based cohort study was conducted.
• Data were sourced from the Trauma Audit & Research Network's (TARN) National Trauma Registry (2019-2020).
• Recidivism was defined as a second admission with different injuries within one year of the initial admission; analysis was descriptive.

Main Results:

• The study included 2517 patients (5136 admissions), with a median age of 81 years; 75% were aged 65 or older.
• The most common injury mechanism for both first and subsequent admissions was a fall from ≤2 meters (86% and 89%, respectively).
• Severe injuries increased from 33% to 39%, and home discharge decreased from 71% to 58% between first and second admissions; mortality on second admission was 10.2%.

Conclusions:

• Trauma recidivism in England and Wales primarily involves elderly individuals with recurrent low-energy falls.
• Prevention strategies should emphasize early, comprehensive multidisciplinary team involvement, including geriatricians and allied health professionals.
• Targeted interventions for patients aged 65 and above who meet TARN inclusion criteria are recommended.