Do entrapment, injuries, outcomes and potential for self-extrication vary with age? A pre-specified analysis of the UK trauma registry (TARN)
| dc.contributor.author | Nutbeam, Tim | |
| dc.contributor.author | Kehoe, Anthony | |
| dc.contributor.author | Fenwick, Rob | |
| dc.contributor.author | Smith, Jason | |
| dc.contributor.author | Bouamra, Omar | |
| dc.contributor.author | Wallis, Lee | |
| dc.contributor.author | Stassen, Willem | |
| dc.date.accessioned | 2022-04-11T21:20:01Z | |
| dc.date.available | 2022-04-11T21:20:01Z | |
| dc.date.issued | 2022-03-05 | |
| dc.date.updated | 2022-03-06T04:09:31Z | |
| dc.description.abstract | Background: Motor vehicle collisions (MVCs), particularly those associated with entrapment, are a common cause of major trauma. Current extrication methods are focused on spinal movement minimisation and mitigation, but for many patients self-extrication may be an appropriate alternative. Older drivers and passengers are increasingly injured in MVCs and may be at an increased risk of entrapment and its deleterious effects. The aim of this study is to describe the injuries, trapped status, outcomes, and potential for self-extrication for patients following an MVC across a range of age groups. Methods This is a retrospective study using the Trauma Audit and Research Network (TARN) database. Patients were included if they were admitted to an English hospital following an MVC from 2012 to 2019. Patients were excluded when their outcomes were not known or if they were secondary transfers. Simple descriptive analysis was used across the age groups: 16–59, 60–69, 70–79 and 80+ years. Logistic regression was performed to develop a model with known confounders, considering the odds of death by age group, and examining any interaction between age and trapped status with mortality. Results 70,027 patients met the inclusion criteria. Older patients were more likely to be trapped and to die following an MVC (p < 0.0001). Head, abdominal and limb injuries were more common in the young with thoracic and spinal injuries being more common in older patients (all p < 0.0001). No statistical difference was found between the age groups in relation to ability to self-extricate. After adjustment for confounders, the 80 + age group were more likely to die if they were trapped; adjusted OR trapped 30.2 (19.8–46), not trapped 24.2 (20.1–29.2). Conclusions Patients over the age of 80 are more likely to die when trapped following an MVC. Self-extrication should be considered the primary route of egress for patients of all ages unless it is clearly impracticable or unachievable. For those patients who cannot self-extricate, a minimally invasive extrication approach should be employed to minimise entrapment time. | en_US |
| dc.identifier.apacitation | Nutbeam, T., Kehoe, A., Fenwick, R., Smith, J., Bouamra, O., Wallis, L., & Stassen, W. (2022). Do entrapment, injuries, outcomes and potential for self-extrication vary with age? A pre-specified analysis of the UK trauma registry (TARN). <i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine</i>, 30(1), 14. http://hdl.handle.net/11427/36338 | en_ZA |
| dc.identifier.chicagocitation | Nutbeam, Tim, Anthony Kehoe, Rob Fenwick, Jason Smith, Omar Bouamra, Lee Wallis, and Willem Stassen "Do entrapment, injuries, outcomes and potential for self-extrication vary with age? A pre-specified analysis of the UK trauma registry (TARN)." <i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine</i> 30, 1. (2022): 14. http://hdl.handle.net/11427/36338 | en_ZA |
| dc.identifier.citation | Nutbeam, T., Kehoe, A., Fenwick, R., Smith, J., Bouamra, O., Wallis, L. & Stassen, W. 2022. Do entrapment, injuries, outcomes and potential for self-extrication vary with age? A pre-specified analysis of the UK trauma registry (TARN). <i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.</i> 30(1):14. http://hdl.handle.net/11427/36338 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Nutbeam, Tim AU - Kehoe, Anthony AU - Fenwick, Rob AU - Smith, Jason AU - Bouamra, Omar AU - Wallis, Lee AU - Stassen, Willem AB - Background: Motor vehicle collisions (MVCs), particularly those associated with entrapment, are a common cause of major trauma. Current extrication methods are focused on spinal movement minimisation and mitigation, but for many patients self-extrication may be an appropriate alternative. Older drivers and passengers are increasingly injured in MVCs and may be at an increased risk of entrapment and its deleterious effects. The aim of this study is to describe the injuries, trapped status, outcomes, and potential for self-extrication for patients following an MVC across a range of age groups. Methods This is a retrospective study using the Trauma Audit and Research Network (TARN) database. Patients were included if they were admitted to an English hospital following an MVC from 2012 to 2019. Patients were excluded when their outcomes were not known or if they were secondary transfers. Simple descriptive analysis was used across the age groups: 16–59, 60–69, 70–79 and 80+ years. Logistic regression was performed to develop a model with known confounders, considering the odds of death by age group, and examining any interaction between age and trapped status with mortality. Results 70,027 patients met the inclusion criteria. Older patients were more likely to be trapped and to die following an MVC (p < 0.0001). Head, abdominal and limb injuries were more common in the young with thoracic and spinal injuries being more common in older patients (all p < 0.0001). No statistical difference was found between the age groups in relation to ability to self-extricate. After adjustment for confounders, the 80 + age group were more likely to die if they were trapped; adjusted OR trapped 30.2 (19.8–46), not trapped 24.2 (20.1–29.2). Conclusions Patients over the age of 80 are more likely to die when trapped following an MVC. Self-extrication should be considered the primary route of egress for patients of all ages unless it is clearly impracticable or unachievable. For those patients who cannot self-extricate, a minimally invasive extrication approach should be employed to minimise entrapment time. DA - 2022-03-05 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine KW - Older patients KW - Extrication KW - Accidents KW - Traffic KW - Spinal injury KW - Emergency Medical Services LK - https://open.uct.ac.za PY - 2022 T1 - Do entrapment, injuries, outcomes and potential for self-extrication vary with age? A pre-specified analysis of the UK trauma registry (TARN) TI - Do entrapment, injuries, outcomes and potential for self-extrication vary with age? A pre-specified analysis of the UK trauma registry (TARN) UR - http://hdl.handle.net/11427/36338 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s13049-021-00989-w | |
| dc.identifier.uri | http://hdl.handle.net/11427/36338 | |
| dc.identifier.vancouvercitation | Nutbeam T, Kehoe A, Fenwick R, Smith J, Bouamra O, Wallis L, et al. Do entrapment, injuries, outcomes and potential for self-extrication vary with age? A pre-specified analysis of the UK trauma registry (TARN). Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2022;30(1):14. http://hdl.handle.net/11427/36338. | en_ZA |
| dc.language.iso | en | en_US |
| dc.language.rfc3066 | en | |
| dc.publisher.department | Division of Emergency Medicine | en_US |
| dc.publisher.faculty | Faculty of Health Sciences | en_US |
| dc.rights.holder | The Author(s) | |
| dc.source | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | en_US |
| dc.source.journalissue | 1 | en_US |
| dc.source.journalvolume | 30 | en_US |
| dc.source.pagination | 14 | en_US |
| dc.source.uri | https://substanceabusepolicy.biomedcentral.com/ | |
| dc.subject | Older patients | en_US |
| dc.subject | Extrication | en_US |
| dc.subject | Accidents | en_US |
| dc.subject | Traffic | en_US |
| dc.subject | Spinal injury | en_US |
| dc.subject | Emergency Medical Services | en_US |
| dc.title | Do entrapment, injuries, outcomes and potential for self-extrication vary with age? A pre-specified analysis of the UK trauma registry (TARN) | en_US |
| dc.type | Journal Article | en_US |