Paper| Volume 26, ISSUE 1, P51-54, January 1995

The epidemiology of major injuries in Mersey Region and North Wales

      This paper is only available as a PDF. To read, Please Download here.


      A prospective epidemiological study was undertaken to determine the workload and patient characteristics for a putative trauma centre in a large defined area. One thousand and eighty-eight patients were included: 430 brought in dead, 309 hospital deaths and 349 survivors. Types of injury were: blunt 76 per cent, penetrating 3.6 per cent, burns 5.8 per cent, other 14 per cent. The incidence of blunt injury was Math Eq for patients arriving alive at hospital and accounted for 0.08 per cent of new A & E attendances. Eight per cent of blunt injury patients were children, 68 per cent were adults and 24 per cent elderly. Major causes of injury were: road accidents 67 per cent and falls 26 per cent. In patients arriving alive after blunt injuries, those who subsequently died were significantly older, more severely injured and more physiologically impaired. Hospital mortality was 45 per cent for blunt, 43 per cent for penetrating injuries, and 67 per cent for burns. TRISS methodology indicated 53 per cent of hospital deaths from blunt injuries were unexpected. Practically, it is questionable whether the incidence of major injuries is sufficient to provide the volume of patients necessary to sustain a Level I Trauma Centre. Nevertheless, concentration of injury service is essential, since no hospital receives sufficient patients to develop and maintain expertise.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • National Academy of Sciences/National Research Council
        Accidental death and disability: the neglected disease of modern society.
        NAS/NRC, Washington, DC1966
        • Anderson ID
        • Woodford M
        • de Dombal FT
        • et al.
        Retrospective study of 1000 deaths from injury in England and Wales.
        Br Med J. 1988; 296: 1305
        • Office of Population Censuses and Surveys
        3rd edn. Mortality Statistics: 1985, England and Wales. HMSO, London1987 (DH1 No. 17)
        • Office of Population Censuses and Surveys
        3rd edn. Mortality Statistics: Accidents and Violence: 1985 England and Wales. HMSO, London1987 (DH4 No. 11)
        • Office of Population Censuses and Surveys
        3rd edn. Mortality Statistics: Area, 1985 England and Wales. HMSO, London1987 (DH5 No. 12)
        • Royal College of Surgeons of England
        3rd edn. The Management of Patients with Major Injuries. RCSE, London1988
        • Baker SP
        • O'Neill B
        • Haddon Jr, W
        • et al.
        The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care.
        J Trauma. 1974; 14: 187
        • Baker SP
        • O'Neill B
        The injury severity score: an update.
        J Trauma. 1976; 16: 882
        • Champion HR
        • Sacco WJ
        • Carnazzo AJ
        • et al.
        Trauma score.
        Crit Care Med. 1981; 9: 672
        • Boyd CR
        • Tolson MA
        • Copes WS
        Evaluating trauma care: the TRISS Method.
        J Trauma. 1987; 27: 370
        • Little RA
        • Gorman D
        • Allgower M
        The shock index revisited.
        in: Vincent JL Update in Intensive Care and Emergency Medicine. Springer Verlag, Berlin1990
        • American Association for Automotive Medicine
        3rd edn. The Abbreyiated Injury Scale. AAAM, Arlington Heights, IL1985 (1985 Revision)
        • Baker SP
        Injuries: the neglected epidemic.
        in: Stone Lecture, 1985 American Trauma Society Meeting. 3rd edn. J Trauma. 27. 1987: 343
        • Office of Population Censuses and Surveys
        3rd edn. Mortality Statistics: Accidents and Violence, 1988 England and Wales. HMSO, London1990 (DH4 No. 14)
        • Office of Population Censuses and Surveys
        3rd edn. Mortality Statistics: Serial Tables 1841–1985, England and Wales. HMSO, London1989 (DH1 No. 19)
        • Smith RF
        • Frateschi L
        • Sloan EP
        • et al.
        The impact of volume on outcome in seriously injured trauma patients: two years experience of the Chicago trauma system.
        J Trauma. 1990; 30: 1066
        • Committee on Trauma of the American College of Surgeons
        Hospital and prehospital resources for optimal care of the injured patient.
        Bull Am Coll Surg. 1986; 71: 4
        • Cales RH
        • Trunkey DD
        Preventable trauma deaths.
        JAMA. 1985; 254: 1059
        • Kreis DJ
        • Plasencia G
        • Augenstein D
        • et al.
        Preventable trauma deaths: Dade County, Florida.
        J Trauma. 1986; 26: 649
        • Shackford SR
        • Hollingworth-Fridlund P
        • Cooper GF
        • et al.
        The effect of regionalisation upon the quality of trauma care as assessed by concurrent audit before and after institution of a trauma system: a preliminary report.
        J Trauma. 1986; 26: 812