Trauma recidivism in England and Wales: an epidemiological study.

BACKGROUND

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.

METHODS

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.

RESULTS

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%.

CONCLUSIONS

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 OF EVIDENCE

Level III.