Socioeconomic Deprivation and 30-Day Mortality Following Major Trauma in Wales

Aim To investigate the association between socioeconomic deprivation and 30-day mortality in a Welsh major trauma cohort. Methods A retrospective cohort study of 676 adult major trauma patients presenting to the University Hospital of Wales (Cardiff) over a one-year period was performed. Socioeconomic status was determined using the Welsh Index of Multiple Deprivation (WIMD) quartiles. Multivariable logistic regression was performed adjusting for age, sex, injury severity score (ISS) and mechanism of injury. Results The most deprived quartile were younger (64 years vs 75 years, p<0.001) and more male dominated (71% vs 55%, p=0.009) in comparison to the least deprived quartile. Increasing age (OR 1.09 per year, p<0.001) and male sex (OR 1.97, p=0.047) were associated with mortality. Patients in the most deprived quartile compared to the least deprived quartile had a higher odds of mortality within 30 days following major trauma (OR 2.51, p=0.037). ISS ≥25 was associated with higher 30-day mortality against an ISS of <9 (OR 3.35, p=0.030). Mechanisms of injury were not significant after adjustment. Conclusion Socioeconomic deprivation is associated with increased 30-day mortality following major trauma after adjustment for age, sex, ISS and mechanism of injury.