“This data shows the volume and complexity of trauma work that University Hospital Galway manages. Our clinical teams are providing an essential, life-saving service for the entire region while managing an increasing caseload,” according to Dr Alan Hussey, Clinical Director of Saolta’s Perioperative Directorate, who was reflecting on a study carried out by doctors at University Hospital Galway (UHG) which revealed the changing presentation of trauma patients, with a doubling of cases and older patient profile emerging over the course of a decade.

Based on critical care data from UHG, the study looked at the characteristics of trauma patients, the nature of their injuries and trends in mortality rates over a 10-year period.  A total of 709 major trauma patient admissions between 2010 and 2021 were reviewed as part of the study (major trauma is defined as serious injury with the potential of causing death and disability).

Dr Ciara Hanley, UHG Consultant Anaesthesiologist and lead author of the study explained how “trauma remains one of the most common causes of death and disability worldwide. Over the last decade, we have seen a significant change in the pattern and demographic of major trauma presenting to our centre, and in those requiring critical care input.”

In the 10-year period, trauma cases doubled and patients aged 65 and older accounted for 45.7% of all admissions. Within this older group, 47.5% of patients were aged 80 and over. The study found that the majority of these older patients had good outcomes overall – most underwent surgical intervention and were discharged from critical care within 48 hours.

Overall,  97.6% of cases had blunt force trauma injuries caused by either a fall (45.4%) or a road traffic accident (29.2%). Orthopaedic, thoracic and spinal trauma were the most frequent organ systems injured (53%, 37% and 32.5% respectively). Admissions are predominately male. Frailty has a significant adverse impact on older patients including increased 30-day mortality, increased incidence of complications, delayed discharge, and increased readmission rates.

The study highlights the high quality specialist care delivered by the critical care team in UHG which is a designated TUSS (Trauma Unit with Specialist Services). A total of 400 patients underwent surgical treatment at the regional site and only 51 patients required an inter-hospital transfer for specialist management not provided in UHG.

Chris Kane, GUH Hospital Manager noted how the study contains “many useful learnings for us as we strive to deliver excellence in trauma care in light of a changing demographic and an increasing incidence of older patients who can have multiple and complex care needs. It is also important to acknowledge the incredible work being carried out by our critical care team who are seeing a sustained increase in demand over recent years.”

Reflecting on the national trauma system, Dr Hanley further explained how “University Hospital Galway plays a pivotal and unique role within the trauma network in Ireland. The Major Trauma Audit National Report in 2018 led to the transformation of structures and processes in relation to trauma management in Ireland, delivering a national high-quality graded hub-and-spoke network of trauma services in line with international best practice.”

Prof John Laffey, UHG Consultant in Anaesthesia and Intensive Care Medicine concluded that “as a Trauma Unit with Specialist Services, our hospital is uniquely positioned to deliver exceptional care, despite the challenges posed by our extensive catchment area and the prolonged transfer time to the Major Trauma Centre. The doubling of critical care trauma admissions over the past decade underscores the increasing demand for our services, particularly among older adults.”