Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: a cross-sectional review of TARN data
Objectives The aim is to compare adolescent (10–24.99 years) trauma patterns and interventions to adult (≥25) and paediatric cases (<10) and to identify any transition points.Design and setting Data were collected from the Trauma and Audit Research Network (TARN) over a 10-year period. We con...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/5/e064101.full |
| _version_ | 1797830189069107200 |
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| author | Damian Roland Mark David Lyttle Stephen Mullen Omar Bouamra David James Amy Tolson Ben Watson |
| author_facet | Damian Roland Mark David Lyttle Stephen Mullen Omar Bouamra David James Amy Tolson Ben Watson |
| author_sort | Damian Roland |
| collection | DOAJ |
| description | Objectives The aim is to compare adolescent (10–24.99 years) trauma patterns and interventions to adult (≥25) and paediatric cases (<10) and to identify any transition points.Design and setting Data were collected from the Trauma and Audit Research Network (TARN) over a 10-year period. We conducted a retrospective cross-sectional analysis.Participants After exclusions there were 505 162 TARN eligible cases.Primary and secondary outcome measures To compare adolescent trauma patterns and interventions to those in paediatric and adult cohorts. Identify transition points for mechanism of injury (MOI) and interventions by individual year over the adolescent age range (10–24.99).Results Road traffic accidents are the most common MOI in the adolescent group, in contrast to both the paediatric and adult group where falls <2 m are most common. Violence-related injury (shootings and stabbings) are more common in the adolescent group, 9.4% compared with 0.3% and 1.5% in the paediatric and adult groups, respectively. The adolescent grouping had the highest median Injury Severity Score (ISS) and the highest proportion of interventions. The proportion of cases due to stabbing peaked at age 17 (11.8%) becoming the second most common MOI. The median ISS peaked at 13 at age 18. The percentage of cases that fulfil the definition of polytrauma enters double figures (11.8%) at age 15 reaching a peak of 17.6% at age 18. The use of blood products within the first 6 hours remains around 2% (1.6%–2.8%) until age 15 (3.4%), increasing to 4.7% at age 16.Conclusions Trauma patterns are more closely aligned between adult and paediatric cohorts than adolescence. The highest proportion of trauma interventions occur in the adolescent population. Analysing the adolescent cohort by year of age identified some common points for when descriptors or outcomes altered in frequency, predominantly between the ages of 15–17 years. |
| first_indexed | 2024-04-09T13:32:10Z |
| format | Article |
| id | doaj.art-bd349c261c904051841485c924c90470 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-09T13:32:10Z |
| publishDate | 2023-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-bd349c261c904051841485c924c904702023-05-09T23:00:06ZengBMJ Publishing GroupBMJ Open2044-60552023-05-0113510.1136/bmjopen-2022-064101Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: a cross-sectional review of TARN dataDamian Roland0Mark David Lyttle1Stephen Mullen2Omar Bouamra3David James4Amy Tolson5Ben Watson6Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Children’s Emergency Department, Leicester Royal Infirmary, Leicester, UKEmergency Department, Bristol Royal Hospital for Children, Bristol, UKSchool of Medicine, Queen’s University Belfast, Belfast, UKInstitute of Population Health, Trauma Audit & Research Network, Salford, UKDepartment of Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK2 Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK2 Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, Belfast, UKObjectives The aim is to compare adolescent (10–24.99 years) trauma patterns and interventions to adult (≥25) and paediatric cases (<10) and to identify any transition points.Design and setting Data were collected from the Trauma and Audit Research Network (TARN) over a 10-year period. We conducted a retrospective cross-sectional analysis.Participants After exclusions there were 505 162 TARN eligible cases.Primary and secondary outcome measures To compare adolescent trauma patterns and interventions to those in paediatric and adult cohorts. Identify transition points for mechanism of injury (MOI) and interventions by individual year over the adolescent age range (10–24.99).Results Road traffic accidents are the most common MOI in the adolescent group, in contrast to both the paediatric and adult group where falls <2 m are most common. Violence-related injury (shootings and stabbings) are more common in the adolescent group, 9.4% compared with 0.3% and 1.5% in the paediatric and adult groups, respectively. The adolescent grouping had the highest median Injury Severity Score (ISS) and the highest proportion of interventions. The proportion of cases due to stabbing peaked at age 17 (11.8%) becoming the second most common MOI. The median ISS peaked at 13 at age 18. The percentage of cases that fulfil the definition of polytrauma enters double figures (11.8%) at age 15 reaching a peak of 17.6% at age 18. The use of blood products within the first 6 hours remains around 2% (1.6%–2.8%) until age 15 (3.4%), increasing to 4.7% at age 16.Conclusions Trauma patterns are more closely aligned between adult and paediatric cohorts than adolescence. The highest proportion of trauma interventions occur in the adolescent population. Analysing the adolescent cohort by year of age identified some common points for when descriptors or outcomes altered in frequency, predominantly between the ages of 15–17 years.https://bmjopen.bmj.com/content/13/5/e064101.full |
| spellingShingle | Damian Roland Mark David Lyttle Stephen Mullen Omar Bouamra David James Amy Tolson Ben Watson Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: a cross-sectional review of TARN data BMJ Open |
| title | Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: a cross-sectional review of TARN data |
| title_full | Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: a cross-sectional review of TARN data |
| title_fullStr | Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: a cross-sectional review of TARN data |
| title_full_unstemmed | Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: a cross-sectional review of TARN data |
| title_short | Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: a cross-sectional review of TARN data |
| title_sort | comparison of injury patterns and interventions between adolescent adult and paediatric trauma cases a cross sectional review of tarn data |
| url | https://bmjopen.bmj.com/content/13/5/e064101.full |
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