Two cohorts of severely injured trauma patients, nearly two decades apart: Unchanged mortality but improved quality of life despite higher age

Background: The care for trauma patients has undergone major changes during the last decades. Additionally, many injury prevention measures have been established. The objective of these efforts was to reduce the number of traumatic incidents and to reduce mortality and morbidity in injured patients. The aim of our study was to assess how these measures and improved care have altered trauma mechanisms, occurrence of injuries, treatment, and outcome in the trauma population treated at our trauma center. Methods: Two cohorts of trauma patients with an Injury Severity Score > 15, treated at the University Medical Center Groningen were compared. The first cohort was treated from 1985 to 1990, the second cohort from September 2002 to January 2005. Results: The annual mean number of severely injured patients increased by 76%. Fourteen percent more patients had sustained an injury at home. The mean age increased from 33 +/- 22 years to 41 +/- 23 years. The presence of severe head and neck injuries in the patients increased from 62% to 73%. Inhospital mortality remained unchanged at 25%. The outcome of survivors improved; 67% of patients made a moderate or good recovery versus 40% almost 20 years ago. Conclusions: Striking are the consequences of the aging of the Dutch population: an almost 10-year increase in mean age and a rise in severe head and neck injuries in the population treated at our trauma center. The unchanged mortality and improved outcome of survivors represented the enhanced trauma care