Rachael Doyle

188The Ageing of Major Trauma

Background: Traditionally major trauma has been viewed as a disease of young men involved in high-energy transfer mechanisms. The aim of this study is to describe the demographics, clinical details and outcome of major trauma presenting to a tertiary urban university hospital in Ireland over a 31-month period. Methods: An urban tertiary referral teaching hospital was one of the first institutions in Ireland to contribute to the Trauma Audit & Research Network (TARN) database and has been doing so since September 2013. A number of parameters are presented including demographics, mechanism of injury, Injury Severity Score (ISS), mortality and length of stay. Results: 1,088 patients were included in our TARN dataset from September 1st 2013 – March 31st 2016. 50.7% (n = 551) were male. The mean age at presentation was 63.5 years (standard deviation (SD) 22.1). 582 patients (53.5%) were ≥65 years, with a strong female preponderance 65.6% (n = 382) in that cohort. The most common mechanism of injury was “fall less than 2 meters” (n = 665, 61.1%). In the over 65 years population, 81.7% (n = 367) suffered a fall less than 2 meters. 65.5% had an ISS of 1–14 and 34.4% scored >15. The median ISS was 9 (range 1–57). The mean length of stay was 21.0 days (SD 33.8). 51 patients (5.9%) died, of whom 39 were over the age of 65. Conclusions: Our trauma database included more patients over the age of 65 years than under, and the predominant mechanism of injury was one of low energy i.e. fall from less than 2 meters. Our data is in keeping with other recent studies from large trauma databases. It highlights the need to tailor our major trauma services to the specific needs of the older people.