The TBI REPORTER Executive are delighted to announce the publication of two important REPORTS from the Trauma Audit and Research Network created released prior to it’s closure in 2024.

These are:

“Severe Injury in Children” and “Major Trauma in Older People“.

The “Severe Injury in Children” report from TARN covers the 2019-2020 period and shows the dominance of traumatic brain injury visible on CT scan as the cause of  childhood major trauma hospital admissions  (pg 11/12) in England and Wales. The most important mechanisms of injury are road traffic collisions, falls and,  very sadly, suspected physical abuse of young children under 2. Over this period – which covered the first year of the pandemic – it is very concerning to note that the commonest cause of  death after hospital admission was asphyxiation through self harm –  whereas road traffic collisions had been the commonest cause in the three earlier reports from TARN.

The Major Trauma in Older People report is more historical and takes data from 2014 English and Welsh data during the early period of Regional Trauma Networks in England. However the findings are still true today, namely that Traumatic Brain Injury is the commonest injury and cause of death.

• A fall of <2m is the commonest mechanism of injury in older patients, in contrast to the predominance of road traffic collisions in younger patients. 
• Current prehospital triage systems are not good at identifying older major trauma patients
• Lack of early identification means that initial treatment is more likely to be in a Trauma Unit, and to be undertaken by a more junior doctor. 

• Older patients are much less likely to be transferred to specialist care and have longer times to both investigation and intervention. 
• Older patients are more likely to die, but those who survive do not have a large incidence of disability compared to younger people.
• The death rate increases steeply in older patients from discharge to 1 year – which needs to be taken into account when assessing research outcomes.
• TARN’s remit was to improve the care for victims of major traumatic injury through audit and research. All trauma receiving hospitals submitted data on their major trauma patients. It was closed by the University of Manchester in 2024, data and remaining staff were transferred to the National Major Trauma Registry at NHS-England