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Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: A cross-sectional review of TARN data

Mullen, Stephen; Tolson, Amy; Bouamra, Omar; Watson, Ben; Lyttle, Mark David; Roland, Damian; James, David

Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: A cross-sectional review of TARN data Thumbnail


Authors

Stephen Mullen

Amy Tolson

Omar Bouamra

Ben Watson

Damian Roland

David James



Abstract

Objectives The aim is to compare adolescent (10-24.99 years) trauma patterns and interventions to adult (≥25) and paediatric cases (<10) and to identify any transition points. Design and setting Data were collected from the Trauma and Audit Research Network (TARN) over a 10-year period. We conducted a retrospective cross-sectional analysis. Participants After exclusions there were 505 162 TARN eligible cases. Primary and secondary outcome measures To compare adolescent trauma patterns and interventions to those in paediatric and adult cohorts. Identify transition points for mechanism of injury (MOI) and interventions by individual year over the adolescent age range (10-24.99). Results Road traffic accidents are the most common MOI in the adolescent group, in contrast to both the paediatric and adult group where falls <2 m are most common. Violence-related injury (shootings and stabbings) are more common in the adolescent group, 9.4% compared with 0.3% and 1.5% in the paediatric and adult groups, respectively. The adolescent grouping had the highest median Injury Severity Score (ISS) and the highest proportion of interventions. The proportion of cases due to stabbing peaked at age 17 (11.8%) becoming the second most common MOI. The median ISS peaked at 13 at age 18. The percentage of cases that fulfil the definition of polytrauma enters double figures (11.8%) at age 15 reaching a peak of 17.6% at age 18. The use of blood products within the first 6 hours remains around 2% (1.6%-2.8%) until age 15 (3.4%), increasing to 4.7% at age 16. Conclusions Trauma patterns are more closely aligned between adult and paediatric cohorts than adolescence. The highest proportion of trauma interventions occur in the adolescent population. Analysing the adolescent cohort by year of age identified some common points for when descriptors or outcomes altered in frequency, predominantly between the ages of 15-17 years.

Citation

Mullen, S., Tolson, A., Bouamra, O., Watson, B., Lyttle, M. D., Roland, D., & James, D. (2023). Comparison of injury patterns and interventions between adolescent, adult and paediatric trauma cases: A cross-sectional review of TARN data. BMJ Open, 13(5), Article e064101. https://doi.org/10.1136/bmjopen-2022-064101

Journal Article Type Article
Acceptance Date Mar 30, 2023
Online Publication Date May 9, 2023
Publication Date May 9, 2023
Deposit Date May 26, 2023
Publicly Available Date May 30, 2023
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 13
Issue 5
Article Number e064101
DOI https://doi.org/10.1136/bmjopen-2022-064101
Keywords Paediatrics, trauma management, Child psychiatry, adolescent psychiatry, A&E, care, ambulatory care, emergency medicine, TARN, injury patterns, interventions, paediatric trauma, trauma
Public URL https://uwe-repository.worktribe.com/output/10800895
Publisher URL https://bmjopen.bmj.com/content/13/5/e064101

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