There are about 5000 victims of trauma per year treated in our region's hospitals with 4% of these being aged under 16yrs old and 40% are aged over 75yrs old. Some 1700 are the most seriously injured (ISS>15) with multiple, severe injuries.
The most common causes of major trauma in our region are road traffic collisions and falls from less than 2metres.
We work with others to prevent trauma, and improve the outcomes of those who have suffered major traumatic injuries.
Given 'trauma' involves a wide range of differing injury patterns, we currently use the internationally recognised Injury Severity Score (ISS) system through the Trauma Audit and Research Network (TARN). The ISS scale is from 0 to 75 - the higher the number, the more severe the injuries with an ISS of more than 15 equating to 'major trauma'. For a given ISS with the age of the patient, initial conscious level (GCS) and their other medical problems (co-morbidities), TARN are able to work out a probability of survival for that patient. Within the system, TARN are able to work out from this whether a hospital or network has more survivors or deaths than would be expected.
As of November 2019, East of England Trauma Network has 0.4 fewer survivors than expected per 100 patients. Each hospital within the Network has figures published for their performance on the TARN website - www.tarn.ac.uk
Mortality is a blunt tool to assess outcomes and we look carefully at many other parameters within the pathway including -
- identification of major trauma patients
- time on-scene
- time from scene to hospital
- attendance of an enhanced care team
- most senior doctor seeing the patient within 5 and 30mins
- administration of Tranexamic Acid
- time to CT
- time to theatre
- length of stay
- completion of rehabilitation prescription