The Groningen Trauma Study. Injury patterns in a Dutch trauma centre

During the period 1970-1993, 245,251 visits were recorded in the trauma registry of the University Hospital Groningen, The Netherlands. An analysis of injury antecedents revealed five principal causes (ICD-CM): accidental falls (28%), sports and unspecified accident (26%), traffic (19%), cutting and piercing instruments (10%) and violence (4%). The trend analysis across the 24 year period showed that the incidence of injuries due to traffic and accidental falls decreased, while the rate of injuries due to assault increased 2-fold. Within the subgroup of traffic accidents, injuries caused by cars and motorcycles declined, while bicycle accidents increased dramatically. With respect to sex and age, the highest incidence rate occurred in men of 20-29 years. The overall male to female ration was 1.8. A predominance of male patients was observed in all cause categories, except in accidental falls. In this category, a relatively higher incidence of women was observed. The overall mortality rate was 0.5%, with the highest mortality rate being in women over 70 years. The main three causes of fatal injury concerned traffic (66%), falls (16%) and violence (3%). The injury patterns in the present study are in close agreement with patterns of other large trauma populations. Some discrepancies could be discerned. For example, in traffic injury, most of the victims (66%) concerned were pedestrians and bicyclists and firearms comprised only 1.2% of injuries due to assault. The usefulness of the registry in current community trauma care programmes and the broader perspective of trauma registration in The Netherlands is discussed.