The changing patterns of injury mechanisms and mortality at a major trauma centre in the UK, 2012–2022: the increase in falls from less than two metres requires effective multidisciplinary collaboration and prevention

Introduction As the major trauma demographic has changed in recent years, with low-energy mechanisms becoming increasingly prevalent, it is important to continue to evaluate the mechanisms of injury and their outcomes. Methods A retrospective study was conducted in a major tertiary-level UK trauma centre between 2012 and 2022. Data were collected by the Trauma Audit and Research Network (TARN) representatives at Aintree Hospital. Analysis of 8,894 major trauma admissions was conducted, evaluating injury mechanisms, their mortality and case fatality rates. Results The total annual admissions almost tripled, from 404 to 1,135 (95% CI: 55.6–107.9, p<0.0001, R 2 =0.866), as did annual deaths, from 28 to 72 (95% CI: 3.5–8.0, p=0.0003, R 2 =0.816). The most common cause of major trauma admissions and mortality was a fall of less than 2m, with the proportion of these admissions increasing from 39.6% to 47.8% (95% CI: 0.2–2.0%, p=0.0220, R 2 =0.459) in this period. This was followed by falls of more than 2m and vehicle collisions. Total and injury-specific case fatality rates were unchanged over the period. All admissions’ total case fatality rate was 6.7%; for falls less than 2m, it was 7.0%. The annual case fatality rate for falls more than 2m was 3.2% higher than vehicle collisions (p=0.0021, 95% CI: 1.2–5.9%). Conclusions Despite being an under-focused injury mechanism, the clinical burden from falls less than 2m continues to increase in major trauma centres. This should be considered in local, regional and national trauma prevention strategies.