46 / 66
44
Trauma
7.7.
In the audit period 2011-2012 the VASM started collecting data points on trauma cases where severe bodily injury or
shock, for example from a fall, accident or violence, occurred in patients that required surgery (see Table 7).
The VASM monitors trends, especially in falls, to ensure strategies are implemented to prevent and minimise harm
from falls in the future.
Table 7: Causes of trauma
Trauma causes
2011-2012
2012-2013
2013-2014
2014-2015
Audit period
Fall at home
52 (41.6%)
92 (40.5%)
105 (42.0%)
77 (41.0%)
326 (41.3%)
Fall in a care facility
28 (22.4%)
91 (40.1%)
76 (30.4%)
54 (28.7%)
249 (31.5%)
Fall in hospital
11 (8.8%)
8 (3.5%)
12 (4.8%)
16 (8.5%)
47 (5.9%)
Fall type unknown
2 (1.6%)
3 (1.3%)
6 (2.4%)
5 (2.7%)
16 (2.0%)
Fall other*
8 (6.4%)
13 (5.7%)
19 (7.6%)
10 (5.3%)
50 (6.3%)
Road accident
19 (15.2%)
16 (7.0%)
23 (9.2%)
19 (10.1%)
77 (9.7%)
Violence
5 (4.0%)
4 (1.8%)
9 (3.6%)
7 (3.7%)
25 (3.2%)
Total
125 (100%)
227 (100%)
250 (100%)
188 (100%)
790 (100%)
Note: total n=790 patients.
Audit period 1 July 2011 to 30 June 2015.
Data not available: n=27 (3%).
*includes roads and public venues.
Comments:
•
21.5% (790/3,679) of mortalities reported since January 2012 were attributed to trauma.
•
Of the traumatic events, 87.1% (688/790) were caused by falls, 9.7% (77/790) were caused by traffic
accidents and 3.2% (25/790) were victims of violence.
•
43.1% (296/688) of falls occurred in hospitals or care facilities 47.3% (326/688) falls occurred at home, and
only 9.5% (66/688) elsewhere.
•
The VASM surgical population is at an increased risk of falls due to the acuity of the life threatening pre-
existing conditions, comorbidities and frailty due to advanced age. Therefore, prevention of falls should be
addressed or improved at hospitals, and care facilities should be improved where possible.
•
A review of patient care received by elderly patients undergoing surgery in the UK had similar findings.
(21)
Future analysis should provide greater insight into strategies for improvement in this aspect of patient care,
especially when falls occurred in a care facility and in hospital. In an Australian study, hospital falls were
attributed to the quality of Victorian coded data on external cause of injury due to a fall.
(24)
•
The VASM would like to see a reduction in fall trends in the years to come and will therefore include this in its
educational programs. A study found a reduction in postoperative falls in patients who participated in a
preoperative education program.
(25)
The value of reviewing falls in trauma and orthopaedic cases can be a
powerful tool to unite institutions motivated to assess changing demographics and standards of treatment, and
ultimately institute change.
(26)
Therefore, similar educational strategies could be implemented at Victorian
health care facilities.
5.7%
Fall in hospital
2011-2014
8.5%
Fall in hospital
2014-2015