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The incidence, distribution and clinical patterns of life-threatening and multiple injuries were evaluated within an English Regional Health Authority area. Cases of major injury were identified retrospectively for the 12 month period October 1988 to September 1989 using data from the 16 Accident and Emergency (A&E) units within the Yorkshire Health Region, and coroners' records. There were 968 cases of fatal and serious injury, meeting the criterion of an injury severity score greater than 15, 67 per cent (645) being due to road traffic incidents. Thirty-five per cent (337) died at the scene or before reaching hospital, whilst 65 per cent (631) survived to reach an A&E unit (0.082 per cent of the Region's annual A&E case load), 75 per cent arriving outside of normal office hours. Eleven per cent (72) died prior to ward admission and 34 per cent (213) were immediately transferred to a secondary medical referral centre. Three hundred and sixty-seven patients (38 per cent) survived to be discharged from acute hospital care whilst 188 (19 per cent) died as in-patients. Major injuries were found to be distributed throughout the Authority area in rough proportion to district population density with a regional incidence of 27 cases per 100 000. This study has quantified a group of patients with very specific and specialized needs, but further research and debate is required to decide how these needs are best met.
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- 3rd edn. Health of the Nation; A Strategy for Health in England. HMSO, London1992
- (Platt Report) 3rd edn. Accident and Emergency Services. HMSO, London1962
- (Lewin Report) 3rd edn. Medical Staffing of Accident and Emergency Services. British Medical Association, London1978
- Report of the Trauma Committee of the British Orthopaedic Association; The Management of Skeletal Trauma in the United Kingdom. BOA, London1992 3rd edn.
- Report of the Working Party on the Management of Patients with Major Injuries. RCSE, London1988 3rd edn.
- Trauma mortality in Orange County; the effect of implementation of a regional trauma system.Ann Emerg Med. 1984; 13: 1
- The effect of regionalisation upon the quality of trauma care as assessed by concurrent audit before and after the institution of a trauma system; a preliminary report.J Trauma. 1986; 26: 812
- Preliminary analysis of the care of injured patients in 33 British hospitals: first report of the United Kingdom major trauma outcome study.Br Med J. 1992; 305: 737
- on behalf of the Trauma Research Group: Department of Orthopaedic Surgery))3rd edn. An Incidence Study of Trauma in the North Staffordshire Health District from April 1989 to April 1990. School of Post-Graduate Medicine and Biological Sciences, Keele University, 1991 (
- Key Population and Vital Statistics; Local and Health Authority areas. England and Wales. HMSO, London1989 3rd edn.
- The Abbreviated Injury Scale. AAAM, Des Plaines, IL1990 (1990 revision) 3rd edn.
- Principles for Emergency and Urgent Care in Yorkshire. A Consultation Policy Document. YRHA, Harrogate1992 3rd edn.
- Mortality Statistics; area, England and Wales.HMSO, London1988
- Mortality Statistics; area, England and Wales.HMSO, London1989
- Trauma audit — the use of TRISS.Health Trends. 1988; 20: 94
- Trauma services requirements in a District General Hospital serving a rural area.Br Med J. 1990; 300: 504
- Deaths following trauma, an audit of performance.Ann R Coll Surg Engl. 1991; 73: 53
- Estimating trauma centre workload.J R Coll Surg Edinb. 1992; 37: 128
- Letter.J R Coll Surg Edinb. 1993; 38: 180
- Audit of severely injured patients in the North West of Great Britain.J Bone Joint Surg [Br]. 1993; 75B
- Hospital resources for optimal care of the injured patient.Bull Am Coll Surg. 1979; 64: 43
- The impact of volume on outcome in seriously injured trauma patients; two years' experience of the Chicago trauma system.J Trauma. 1990; 30: 1066
- Trauma centres and the efficient use of resources.Br J Surg. 1990; 77: 1142
Accepted: August 4, 1994
© 1995 Published by Elsevier Inc.