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  • Holmberg, Lina, et al. (author)
  • Penetrating Trauma on the Rise – Nine-year Trends of Severe Trauma in Sweden
  • Other publication (other academic/artistic)abstract
    • PurposeSweden has an established trauma system involving national trauma criteria and a registry, SweTrau, since over a decade. Meanwhile, the injury panorama has evolved, with an increase in gang-related violence in the Swedish community. In this study, we aimed to investigate long-term trends in mortality, management and trauma type in two major Swedish trauma centers over a nine-year period. MethodsAll trauma patients with a New Injury Score (NISS)>15 or a Trauma Alert call during 2013-2021 were identified in the participating centers’ SweTrau registries. Data were analysed regarding mortality, proportion of emergency interventions, intensive care unit (ICU) admissions, mechanism of injury and type of trauma (penetrating or blunt). To assess trends, Chi-Squared test for trend and JoinPoint regression method were used. ResultsA total of 10585 patients were included in the study. Mortality remained unchanged over time in patients with NISS>15 (10.0% - 10.9%, p=0.963) but increased in NISS<15 (1.3% - 2.7%, p=0.005), partly comprising penetrating trauma, suicides and traumatic cardiac arrests. For NISS>15, the proportion undergoing emergency interventions was stable (53.9%-48.8%, p=0.297) while ICU admissions declined (62.1%-45.7%, p<0.001). Penetrating trauma increased (12.4%-19.6%, p<0.001), including knife (10.0%-15.7%, p<0.001) and gunshot wounds (2.3%-3.8%, p<0.001), whereas accidents involving motorcycles (8.8%-7.0%, p=0.004) and pedestrians (5.3%-2.2%, p<0.001) decreased. ConclusionsIn this trend analysis at two major Swedish trauma centers during 2013-2021, penetrating trauma increased with over 50% while traffic injuries decreased. The rise in mortality in patients with NISS<15 is concerning and requires further evaluation, as do the reduction in ICU admissions. 
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