Falls from less than two metres most common cause of injury - report

Falls from less than two metres are the most common cause of an injury that can result in prolonged disability or death, it has emerged.

Such injuries account for 58% of all major trauma in Ireland — and more than three-quarters (78%) occur in the home.

The Major Trauma Audit National Report from the National Office of Clinical Audit shows that low falls continue to be the most frequent cause of severe injury.

Dr Conor Deasy, clinical lead for major trauma audit, on the report, said fall injuries were the most common and preventable cause of major trauma in Ireland.

“Our audit shows that when it comes to major trauma, walking in the front door of your home can be more dangerous than walking out of your front door — the majority of injuries are being caused by falls at home.”

Dr Deasy said the best system of care is described in a report published by the Department of Health in 2018.

The Trauma System for Ireland Report addresses all elements of trauma care, including prevention, pre-hospital care, acute hospital care, rehabilitation, and supported discharge.

Inclusive trauma systems in similar jurisdictions to Ireland have been found to significantly reduce the number of deaths and disabilities caused by major trauma.

Dr Deasy said they looked forward to the “imminent implementation” of the report.

The audit shows that 20% of patients needed to be transferred to another hospital because their care needs could not be met by the initial receiving hospital.

There were 273 patients who needed a CT brain scan and 48% received it within an hour, a 7% improvement on 2017.

Head injuries accounted for almost one in five (18%) of all major trauma injuries.

The report, launched at the National Office of Clinical Audit’s annual conference, shows 46% of major trauma is sustained in patients over the age of 65.

The older patients who have more complex medical needs do not receive the same level of response as younger patients with the same severity of injury and have considerably worse outcomes.

Only 59% of major trauma patients were discharged directly home following their hospital admission.

The highest proportion of deaths (59%) continues to be due to falls of less than two metres and the highest proportion of deaths occurred in patients aged 75 years and over.

The overall percentage of major trauma patients received by a trauma team at the first receiving hospital remains low, at 8%.

Just 9% of major trauma patients were recorded as having been reviewed by a consultant within 30 minutes of arrival at the emergency department.

Men are more likely than women to sustain a major trauma injury and the highest proportion of deaths (63%) continues to occur in males.

There were 87,768 hospital bed days occupied by major trauma patients in 2018, compared to 82,930 in 2017.

The audit presents data from 5,429 patients across 26 trauma receiving hospitals.

The National Office of Clinical Audit, established in 2012, is funded by the HSE’s quality-improvement team, governed by an independent voluntary board and supported by the Royal College of Surgeons in Ireland.