Inclusion of 'minor' trauma cases provides a better estimate of the total burden of injury: Queensland Trauma Registry provides a unique perspective.
BACKGROUND
Injury is recognised as a frequent cause of preventable mortality and morbidity; however, incidence estimates focusing only on the extent of mortality and major trauma may seriously underestimate the magnitude of the total injury burden. There currently exists a paucity of information regarding minor trauma, and the aim of this study was to increase awareness of the contribution of minor trauma cases to the total burden of injury.


METHODS
The demographics, injury details, acute care factors and outcomes of both minor trauma cases and major trauma cases were evaluated using data from the state-wide trauma registry in Queensland, Australia, from 2005 to 2010. The impact of changes in Abbreviated Injury Scale (AIS) versions on the classification of minor and major injury cases was also assessed.


RESULTS
Over the 6-year period, minor cases [Injury Severity Score (ISS) ≤ 12] accounted for almost 90% of all trauma included on the Queensland Trauma Registry (QTR). These cases utilised more than half a million acute care bed days, underwent more than 66,500 operations, and accounted for more than 48,000 patient transport episodes via road ambulance, fixed wing aircraft, or helicopter. Furthermore, more than 5800 minor trauma cases utilised in-hospital rehabilitation services; almost 3000 were admitted to an ICU; and more than 20,000 were admitted to hospital for greater than one week. When using the contemporary criteria for classifying trauma (AIS 08), the proportion of cases classified as minor trauma (87.7%) and major trauma (12.3%) were similar to the proportion using the traditional criteria for AIS90 (87.9% and 12.1%, respectively).


CONCLUSIONS
This evaluation of minor trauma cases admitted to public hospitals in Queensland detected high levels of demand placed on trauma system resources in terms of acute care bed days, operations, ICU admissions, in-hospital rehabilitation services and patient transportation, and which are all associated with high cost. These data convincingly demonstrate the significant burden of injury imposed by minor trauma cases serious enough to be admitted to hospital.
Centre of National Research on Disability and Rehabilitation Medicine, School of Medicine, The University of Queensland, Brisbane, QLD, Australia. Electronic address: j.lang@uq.edu.au.
Jacelle
J
Lang
Centre of National Research on Disability and Rehabilitation Medicine, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Natalie
N
Dallow
Redcliffe Hospital, Redcliffe, QLD, Australia.
Austin
A
Lang
Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; Centre of National Research on Disability and Rehabilitation Medicine, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Kevin
K
Tetsworth
Centres for Health Research, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
Kathy
K
Harvey
Centre of National Research on Disability and Rehabilitation Medicine, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Cliff
C
Pollard
Centre of National Research on Disability and Rehabilitation Medicine, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Nicholas
N
Bellamy
D015998:Abbreviated Injury Scale; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge; D011793:Queensland / Q000453:epidemiology; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014186:Transportation; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality
Burden of injury; Minor injury; Public health impact