title: A review of major trauma admissions to a tertiary adult referral hospital over a ten year period: fewer patients, similar survival.
abstract: BACKGROUND
  Trauma is an important cause for presentation to the emergency department, representing a significant number of emergency surgical admissions. Societal changes result in alterations in the epidemiology of trauma.
  
  
  OBJECTIVE
  This study aimed to review patients admitted to a tertiary referral hospital as a result of traumatic injuries, assessing for changes in admission epidemiology.
  
  
  METHODS
  Trauma admissions over two year-long periods a decade apart were reviewed. The Trauma Audit and Research Network (TARN) audit system identified admissions and transfers between June 2006 and May 2007. The Hospital In-Patient Enquiry (HIPE) system identified those fulfilling TARN criteria a decade earlier. Comparative analysis was performed on the dataset.
  
  
  RESULTS
  There were 367 trauma admissions between June 2006 and May 2007: 88 road traffic accidents (RTAs), 201 falls and 77 other injuries, with 627 admissions a decade earlier: 286 RTAs, 247 falls and 94 others. Males comprised 72% and 69% of RTA admissions in both periods respectively. Firearm-related injuries increased significantly (p = 0.015). Neurosurgical transfers decreased from 256 to 150 with a slight increase in unadjusted overall mortality from 8.5% to 10.9%. Admissions of patients aged less than 19 reduced from 150 to 59 (p = 0.0031) with a similar trend in those aged between 20 and 29 years from 149 to 78.
  
  
  CONCLUSIONS
  Admissions resulting from RTAs and of patients aged under 30 reduced significantly, however, young males remain the most affected sub-group. Firearm injuries increased significantly, a worrying trend in view of the severity of injury sustained by these victims.
authors.affiliation: Department of Surgery, Beaumont Hospital, Dublin, Ireland. gemmasolon@gmail.com
authors.forename: J G
authors.initials: JG
authors.lastname: Solon
authors.forename: P
authors.initials: P
authors.lastname: Houlihan
authors.forename: D F
authors.initials: DF
authors.lastname: O'Brien
authors.forename: S
authors.initials: S
authors.lastname: Connolly
authors.forename: D
authors.initials: D
authors.lastname: O'Toole
authors.forename: D A
authors.initials: DA
authors.lastname: McNamara
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult