The magnitude of traumatic injury as a public health problem is enormous. In terms of years of productive life lost, prolonged or permanent disability, and cost, traumatic injury is now recognized as one of the most important threats to public health and safety in the United States. As such, the prevention of traumatic injury and the provision of trauma care are regarded as public services central to the mission of public health agencies.
Statistically speaking males account for the majority of injuries, but we are seeing a steady increase of those over 65 years of age. Some gender characteristics include, males accounted for 55.2% of reportable trauma cases in 2011, representing 6,319 cases. Females accounted for 44.7%, representing 5,129 trauma cases. Figure 7 illustrates how the 2011 gender distribution compares to the average for years 2001-2007 as well as the average for years 2008-2010.
The number of trauma cases involving patients over the age of 65 has steadily increased since the inclusion criteria were changed in 2008. In 2011, there was a dramatic increase in the number of traumatic injuries in the population older than 85. In 2011, 1,445 such cases were recorded in the trauma registry. Six hundred and twenty-two of those (43%) involved fractures of the hip and/or femur.
In 2011, 87.4% of all trauma cases involved residents of the state, with 12.6% (1,437) of cases involving non-residents. Based on 2010 emergency department data (the last year for which data are available), 95% of encounters involved state residents. These figures indicate a higher incidence of traumatic injury involving non-residents.
Although the incidence of traumatic injuries remains somewhat stable from month to month, there is a slight increase during the summer months of June, July and August. Holidays do not pose a significant increase in occurrence, and while rates are generally stable across the week, there is a slight increase in trauma events on Saturdays.
Based upon the primary qualifying diagnosis, there were 25 different causes of traumatic injury in Utah during 2011. These ranged in prevalence from one case (smoke inhalation) to 6,214 cases (falls). For ease of reporting, the top six causes are shown below along with the total of all other causes. Data are shown for both 2011 values and the 10-year average.
- “Fall” includes all falls, whether from one level to another or ground-level.
- “Motorcycle crash” includes motorcycle with motor vehicle incidents.
- “Other vehicular cause” includes three- and four-wheel ATVs.
- “Bicycle crash” includes bicycle with motor vehicle incidents.
The dramatic increase in falls warrants special attention. Since 2008, the trauma registry has included ground level falls in the elderly resulting in traumatic injuries. This change in inclusion criteria is reflected in the variance between 2011 data and the 10-year average.
There is a strong correlation between falls in the elderly and hip fractures. The average number of hip fractures included in the registry between 2001 and 2007 was 261 females and 234 males per year. Since the change in inclusion criteria, those averages have increased to 1,553 females and 568 males per year. This dramatic change also helps explain the narrowing of the gender gap, since significantly more women than men have been treated for hip fractures since 2008.
Trauma Registry Report—2011
Annual report based on Utah’s Statewide Trauma Registry Data
Utah Department of Health
Bureau of Emergency Medical Services and Preparedness