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Ageing population has changed the nature of major thoracic injury
  1. Noha Ferrah1,
  2. Peter Cameron1,
  3. Belinda Gabbe2,
  4. Mark Fitzgerald3,
  5. Rodney Judson4,
  6. Silvana Marasco5,
  7. Tanya Kowalski3,
  8. Ben Beck2
  1. 1 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  3. 3 Trauma Service, Alfred Hospital, Melbourne, Victoria, Australia
  4. 4 Trauma Services, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
  5. 5 Cardiothoracic Unit, Alfred Hospital, Melbourne, Australia
  1. Correspondence to Dr Noha Ferrah, School of Public Health, Monash university, Melbourne, VIC 3004, Australia; noha.ferrah{at}


Introduction An increasing proportion of the major trauma population are older persons. The pattern of injury is different in this age group and serious chest injuries represent a significant subgroup, with implications for trauma system design. The aim of this study was to examine trends in thoracic injuries among major trauma patients in an inclusive trauma system.

Methods This was a retrospective review of all adult cases of major trauma with thoracic injuries of Abbreviated Injury Scale score of 3 or more, using data from the Victorian State Trauma Registry from 2007 to 2016. Prevalence and pattern of thoracic injury was compared between patients with multitrauma and patients with isolated thoracic injury. Poisson regression was used to determine whether population-based incidence had changed over the study period.

Results There were 8805 cases of hospitalised major trauma with serious thoracic injuries. Over a 10-year period, the population-adjusted incidence of thoracic injury increased by 8% per year (incidence rate ratio [IRR] 1.08, 95% CI 1.07 to 1.09). This trend was observed across all age groups and mechanisms of injury. The greatest increase in incidence of thoracic injuries, 14% per year, was observed in people aged 85 years and older (IRR 1.14, 95% CI 1.09 to 1.18).

Conclusions Admissions for thoracic injuries in the major trauma population are increasing. Older patients are contributing to an increase in major thoracic trauma. This is likely to have important implications for trauma system design, as well as morbidity, mortality and use of healthcare resources.

  • trauma
  • chest
  • research
  • epidemiology

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  • Contributors All authors have contributed significantly and are in full agreement with the content of the manuscript.

  • Funding BB was supported by an Australian Research Council Discovery Early Career Researcher Award Fellowship (DE180100825). PC was supported by a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (No 545926). BG was supported by an Australian Research Council Future Fellowship (FT170100048). The database from which the data were extracted (the VSTR) is a Department of Health, State Government of Victoria and Transport Accident Commission funded project.

  • Competing interests None declared.

  • Ethics approval The VSTR has approval from institutional ethics committees of all 138 trauma-receiving hospitals. This work has received ethics approval from the Monash University Human Research Ethics Committee (MUHREC).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.