Individual and population burdens of major trauma in the Netherlands.
OBJECTIVE
To assess the impact of major trauma on individual and population health.


METHODS
Data from a regional trauma registry were used, including all trauma fatalities and nonfatal severely injured patients (injury severity score >15) in 1999 and 2000. The impact of fatalities was expressed in terms of years of life lost (YLL). The impact of severe injury on survivors was expressed in terms of years lived with disability (YLD). Disability weights were based on quality of life at 15 months after injury, measured with EuroQol-5D. Disability-adjusted life years (DALYs) were calculated as the sum of YLLs and YLDs.


RESULTS
There were 567 fatalities and 335 survivors. At the individual level, trauma fatalities (32 YLLs per patient) and nonfatal cases of major trauma (12 YLDs per patient) both led to a substantial loss of healthy life years. Each victim of major trauma contributed an average of 25 DALYs to the burden of disease. At the population level, major trauma caused 10 DALYs per 1000 inhabitants. Road-traffic injury was the main contributor to the population burden of major trauma.


CONCLUSIONS
Both at individual and population levels, major trauma has a massive impact on health. Most severely injured victims of road-traffic crashes reach the hospital and have good chances of survival. Injury prevention and trauma care policies should aim at further reduction of both fatalities and permanent consequences among survivors.
Holtslag
Herman R
HR
Department of Rehabilitation and Sports Medicine, Rehabilitation Center De Hoogstraat, University Medical Center, Utrecht, the Netherlands. H.R.Holtslag@umcutrecht.nl
van Beeck
Eduard F
EF
Lichtveld
Rob A
RA
Leenen
Loek Ph
LP
Lindeman
Eline
E
van der Werken
Chris
C
D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data; D000328:Adult; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011634:Public Health; D011788:Quality of Life; D012042:Registries; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality