Highlights from the American College of Surgeons
National Trauma Data Bank (NTDB)

The 2002 Report of the National Trauma Data Bank (NTDB) represents the largest aggregation of trauma center registry data ever assembled, containing more than 400,000 cases from over 130 hospitals in 28 states. The NTDB was established by the American College of Surgeons for use by trauma program directors, hospital administrators, health planners, and government agencies to help them better understand some of the many issues associated with injured patients and their care.

Between 2001 and 2002, the number of cases reported to the data bank doubled, and with the adoption of new data collection methods it holds promise of even more rapid growth. Because the greatest amount of data was collected in recent years and reflects only a portion of the nation's trauma services, the insights provided should be viewed as a "snapshot" or baseline that will ultimately allow us to develop ways to improve care and develop effective injury prevention programs. Developing trends should become more apparent in future years as additional data are collected.

Following are some of the key points from the current data set:

• The majority of the trauma patients under age 68 were male.
• There are three distinct "peaks" in the incidence of trauma:
  • The number of patients is greatest between the ages of 18 and 21. This group is dominated by males who were injured by violence and in motor vehicle crashes.
  • Males also predominate the second peak between ages 36-37. Again, motor vehicle crashes and violence are the principal causes of injury.
  • Women between the ages of 76 and 80 who are injured in falls and motor vehicle crashes comprise most of the third peak.
• The percentages of deaths for injuries of varying severity are relatively constant until about age 50, when they begin to increase steadily with age.
• Motor vehicle crashes are the most common mechanism of injury and account for 38 percent of all injuries. The number of these injuries is relatively stable up to age 14, where there is a dramatic rise that peaks at age 20. Motor vehicle deaths occurred in 5 percent of cases, but because there are so many they account for the largest number of deaths, hospital days, and ICU days.
• Falls are the second most common mechanism of injury, accounting for 30 percent of all patients; 3.6 percent of them resulted in death. Death rates increase steadily with age, from 0.16 percent for children ages 5-9, to 6.97 percent for the very old (over age 95). The number of injuries due to falls peaks between the ages of 75 and 84 (about 17 percent of all fall injury patients).
• Injuries due to violence (gunshot wounds, stabbings, fights) are the third most common cause of injury (11 percent). Most violent deaths are due to gunshot wounds, which have the highest mortality rate of all types of injury (16.2 percent).
• Self-pay (21 percent), Medicare (17 percent), commercial indemnity plans (15 percent ), managed care (13 percent), and Medicaid (11 percent) are the principal payment sources. Automobile insurance was the source of payment for less than 5 percent of cases.

Profile of the Injuries
1994-2001
(Data collected from 130 trauma centers)

Mechanism of Injury	Number of Patients	Mechanism as % of Total Patients	Mortality Rate for Mechanism	% of Total Hospital Length of Stay (Days)	Average Hospital Length of Stay (Days)
Motor Vehicle Crashes	95,807	38.17%	5.04%	40.55%	5.87
Falls	76,410	30.44%	3.60%	28.22%	5.12
Firearms	16,526	6.58%	16.15%	7.52%	6.31
Pedestrian	12,742	5.08%	9.15%	6.91%	7.52
Motorcycle Crashes	11,930	4.75%	5.00%	5.62%	6.53
Assault/Fight	11,809	4.70%	1.91%	3.45%	4.05
Stab	11,124	4.43%	2.62%	2.70%	3.36
Machinery	6,860	2.73%	1.69%	2.23%	4.51
Pedal Cycle	6,122	2.44%	2.92%	1.80%	4.07
Burns	1,665	0.66%	6.43%	1.01%	8.43
Source: National Trauma Data Bank Report 2002

More information about the NTDB and the full text of the 2002 report can be found on the American College of Surgeons Web site at http://www.facs.org/dept/trauma/ntdb.html.

 American College of Surgeons Examines U.S. Trauma Care

Online May 28, 2003