A population-based assessment of major trauma in a large Canadian region.

Background: The cause of major trauma has not been well defined using population-based methodologies.

Methods: We performed a population-based surveillance of major traumatic injuries in adult residents of the Calgary Health Region over a period of 3 years.

Results: A total of 1,475 victims of major trauma were identified (69.5 per 100,000/y). Males were at significantly higher risk as compared with females (104.5 vs. 35.2 per 100,000; relative risk = 3.0, 95% confidence interval = 2.64-3.35), as were urban as compared with rural residents (70.7 vs. 49.0 per 100,000; relative risk = 1.4; 95% confidence interval = 1.11-1.91). A strikingly high incidence rate of major trauma was observed among those aged 85 years or more at 242.3 per 100,000 per year; elderly men were at 16.8-fold (95% confidence interval = 11.04-24.79) higher risk than young females. The majority were unintentional (53.9 per 100,000/y). Suicide, assault, and homicide occurred at annualized rates of 8.5, 4.8, and 1.6 per 100,000, respectively. Motor vehicle-related injuries (39%), falls or jumps (33%), and being struck by an object or animal (10%) were responsible for the majority of traumas. Firearm injuries were relatively uncommon (2.0 per 100,000/y). The annual mortality rate was 20.0 per 100,000.

Conclusions: This study provides rigorous, population-based data on the cause of severe injury in the Calgary Health Region. It is hoped that ongoing work in this area will be useful in the development of effective injury prevention and health resource allocation strategies.