McNickle Luke, Wohlgemut Jared M, Ramsay George, Jansen Jan O
University of Glasgow, Glasgow, UK.
Centre for Trauma Sciences, Blizzard Institute, Queen Mary University of London, London, UK.
Trauma Surg Acute Care Open. 2025 Jul 15;10(3):e001669. doi: 10.1136/tsaco-2024-001669. eCollection 2025.
Trauma recidivism refers to patients who are injured repeatedly. There has been no evaluation of trauma recidivism in England and Wales. We hypothesize that, because population demographics and predominant trauma mechanism differ from other studied populations, the typical demographics of patients suffering repeated trauma would differ. Our aim was to determine the demographic and injury characteristics, and outcomes of patients suffering repeated trauma.
This was a national, retrospective, population-based cohort study of patients included in the prospectively collected Trauma Audit & Research Network's (TARN) National Trauma Registry for England and Wales between 2019 and 2020. We defined recidivism as a second admission, with different injuries, within 1 year of the initial admission. Analysis was descriptive.
2517 patients (5136 admissions) were included. Median age at first admission was 81 years, and 1888 (75%) were ≥65 years. 1301 (52%) were female. The most common mechanism of injury at first and second admission was a fall ≤2 m (2159 86%, 2237 89%). 2035 (81%) suffered a fall ≤2 m on both admissions. Patients with severe injury increased from 838 (33%) to 982 (39%) from first to second admission. Patients discharged home decreased from 1776 (71%) to 1449 (58%) from first to second admission. Mortality on 2nd admission was 10.2%.
In England and Wales, trauma recidivism consists primarily of elderly patients who repeatedly suffer low-energy falls. It follows that prevention strategies should consist of greater and earlier involvement of multidisciplinary team input including geriatric physicians and allied health professionals, for anyone ≥65 who fulfills the criteria for TARN inclusion.
Level III.
创伤再发是指患者反复受伤。英格兰和威尔士尚未对创伤再发情况进行评估。我们推测，由于人口统计学特征和主要创伤机制与其他研究人群不同，反复受伤患者的典型人口统计学特征也会有所不同。我们的目的是确定反复受伤患者的人口统计学和损伤特征以及预后情况。
这是一项基于全国前瞻性收集的英格兰和威尔士创伤审计与研究网络（TARN）国家创伤登记处数据的回顾性队列研究。我们将再发定义为首次入院后1年内因不同损伤再次入院。分析采用描述性方法。
共纳入2517例患者（5136次入院）。首次入院时的中位年龄为81岁，其中1888例（75%）年龄≥65岁。1301例（52%）为女性。首次和第二次入院时最常见的损伤机制是跌倒高度≤2米（分别为2159例，86%；2237例，89%）。2035例（81%）患者两次入院均为跌倒高度≤2米。重伤患者从首次入院的838例（33%）增加到第二次入院的982例（39%）。出院回家的患者从首次入院的1776例（71%）减少到第二次入院的1449例（58%）。第二次入院时的死亡率为10.2%。
在英格兰和威尔士，创伤再发主要发生在反复遭受低能量跌倒的老年患者中。因此，对于任何符合TARN纳入标准且年龄≥65岁的患者，预防策略应包括多学科团队（包括老年医学医生和专职医疗人员）更早、更多地参与。
三级。
