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Epidemiology of adolescent trauma in England: a review of TARN data 2008–2017
  1. Zoe Roberts1,
  2. Julie-Ann Collins2,
  3. David James3,
  4. Omar Bouamra4,
  5. Mike Young5,
  6. Mark D Lyttle6,
  7. Damian Roland7,8,
  8. Stephen Mullen2
  9. On behalf of PERUKI
  1. 1 Paediatric Emergency Department, Cardiff and Vale University Health Board, Cardiff, UK
  2. 2 Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
  3. 3 Children's Emergency Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  4. 4 The Trauma Audit and Research Network, Salford, UK
  5. 5 Trauma Audit Research Network, Manchester, UK
  6. 6 Emergency Department, Bristol Royal Children's Hospital, Bristol, UK
  7. 7 Health Sciences, University of Leicester, Leicester, UK
  8. 8 Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Hospitals, Leicester, UK
  1. Correspondence to Stephen Mullen, Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast BT12 6BA, UK; smullen001{at}googlemail.com

Abstract

Objectives Trauma contributes significantly to adolescent morbidity and mortality. We aimed to ascertain the epidemiology of adolescent trauma to inform prevention strategies.

Methods Data were abstracted from TARN (Trauma Audit Research Network) from English sites over a 10-year period (2008–2017). Adolescents were defined as 10–24 completed years. Descriptive statistical analysis was used in this study.

Results There were 40 680 recorded cases of adolescent trauma. The majority were male (77.3%) and aged 16–24 years old (80.5%). There was a 2.6-fold increase during the study time frame (p<0.0001) in the total annual number of cases reported to TARN. To account for increasing hospital participation, the unit trauma cases per hospital per year was used, noting an increasing trend (p=0.048). Road traffic collision (RTC) was the leading cause of adolescent trauma (50.3%). Pedestrians (41.2%) and cyclists (32.6%) were more prevalent in the 10–15 year group, while drivers (22.9%) and passengers (17.8%) predominated in the 16–24 year group. Intentional injury was reported in 20.7% (alleged assault in 17.2% and suspected self-harm in 3.5%). This was more prevalent in the 16–24 year group. The proportion of trauma reported due to violence has increased with stabbings increasing from 6.9% in 2008 to 10.2% in 2017 (p<0.0001). Evidence of alcohol or drug use was recorded in 20.1% of cases. There was an increase in the number treated in major trauma centres (45.7% 2008 vs 63.5% 2017, p<0.0001). Trauma was more likely to occur between 08:00 and 00:00, at weekends and between April and October. Overall mortality rate was 4.1%. Those with a known psychiatric diagnosis had a higher mortality (6.3% vs 4.4%, p<0.001).

Conclusions RTCs and intentional injuries are leading aetiologies. Healthcare professionals and policy-makers need to prioritise national preventative public health measures and early interventions to reduce the incidence of trauma in this vulnerable age group.

  • emergency care systems
  • paediatric emergency med
  • paediatric injury
  • trauma, epidemiology
  • trauma, research
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Footnotes

  • Twitter Mark D Lyttle @mdlyttle and Damian Roland @damian_roland

  • Contributors SM planned this paper, coauthored and reviewed the manuscript. ZR and J-AC aided in the development of this paper, coauthored and reviewed the manuscript. OB and MY aided in data extraction, coauthored and reviewed the manuscript. DR and MDL aided in the development of this paper and reviewed the manuscripts.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval TARN has ethical approval (PIAG section 60) for research using anonymised data that are stored securely on the University of Manchester server. TARN holds HRA CAG section 251 approval for research on anonymised data submitted by member hospitals.

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

  • Data availability statement Data are available on reasonable request.

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