title: Age-related trends in injury and injury severity presenting to emergency departments in New South Wales Australia: Implications for major injury surveillance and trauma systems.
abstract: OBJECTIVE
  To describe population based trends and clinical characteristics of injury related presentations to Emergency Departments (EDs).
  
  
  METHODS
  A retrospective, descriptive analysis of de-identified linked ED data across New South Wales, Australia over five calendar years, from 2010 to 2014.
  
  
  METHODS
  Patients were included in this analysis if they presented to an Emergency Department and had an injury related diagnosis. Injury severity was categorised into critical (triage category 1-2 and admitted to ICU or operating theatre, or died in ED), serious (admitted as an in-patient, excluding above critical injuries) and minor injuries (discharged from ED).
  
  
  METHODS
  The outcomes of interest were rates of injury related presentations to EDs by age groups and injury severity.
  
  
  RESULTS
  A total of 2.09 million injury related ED presentations were analysed. Minor injuries comprised 85.0%, and 14.1% and 1.0% were serious and critical injuries respectively. There was a 15.8% per annum increase in the rate of critical injuries per 1000 population in those 80 years and over, with the most common diagnosis being head injuries. Around 40% of those with critical injuries presented directly to a major trauma centre.
  
  
  CONCLUSIONS
  Critical injuries in the elderly have risen dramatically in recent years. A minority of critical injuries present directly to major trauma centres. Trauma service provision models need revision to ensure appropriate patient care. Injury surveillance is needed to understand the external causes of injury presenting to hospital.
authors.affiliation: Royal Prince Alfred Hospital, Australia; Discipline of Emergency Medicine, The University of Sydney, Australia. Electronic address: michael.dinh@sswahs.nsw.gov.au.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Dinh
authors.affiliation: Royal Prince Alfred Hospital, Australia; Faculty of Nursing, The University of Sydney, Australia.
authors.forename: Saartje Berendsen
authors.initials: SB
authors.lastname: Russell
authors.affiliation: Royal Prince Alfred Hospital, Australia.
authors.forename: Kendall J
authors.initials: KJ
authors.lastname: Bein
authors.affiliation: Queenland University of Technology, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Vallmuur
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Muscatello
authors.affiliation: Royal Prince Alfred Hospital, Australia.
authors.forename: Dane
authors.initials: D
authors.lastname: Chalkley
authors.affiliation: The George Institute for Global Health, The University of Sydney, Australia; School of Nursing and Midwifery, Flinders University, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D012189:Retrospective Studies; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014218:Triage; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D055815:Young Adult
keywords: Emergency Department; Injury; Trauma