Audit of trauma management in Scotland
Reporting on 2020

About this release

This release by Public Health Scotland (PHS) is the eighth report by the Scottish Trauma Audit Group (STAG) since 2011. Compliance with a subset of the Scottish Trauma Network Key Performance Indicators, case-mix adjusted mortality and Patient Reported Outcome Measures (PROMs) are within part one of the report. Part two and three provide a comprehensive summary of injuries and the patient journey for both adults and paediatrics respectively.

Main points

• The audit covered 28 out of 30 hospitals with an Emergency Department (ED). These hospitals treated over 98% of ED attendances in 2020.
• There is no significant change in the number of patients sustaining severe trauma, despite changes in behaviour due to the COVID-19 pandemic.
• STAG is now able to monitor patients who are admitted to a medical specialty (n=941) with a significant injury.

Key Performance Indicators (KPIs)

KPI compliance across Scotland as a whole can be seen in the chart below. Compliance is on par with 2019 despite challenges faced by the trauma community including re-deployment of key staff and repurposing of major trauma wards to support the COVID-19 pandemic.

IV – intravenous, ABx – anti-biotics, TXA – Tranexamic acid, PROMs – Patient Reported Outcome Measures

Patient outcome

• 7% of all patients died in hospital, rising to 20% of patients suffering major trauma.
• The majority of patients, who returned a PROMs questionnaire at six months’ post-injury (n=259), reported improved health and reduced pain.

Patients aged 16 years and over

• STAG report on 5,434 adult patients, of which 20% are classified as having major trauma.
• Falls on the same level are the most common cause of injury for patients aged 65 years and over. Moving vehicle accidents are more common in patients aged less than 65 years for female patients with major trauma and male patients with minor and major trauma.
• Injuries are more common in patients who reside in the most deprived areas.
• There has been a reduction in incidents involving alcohol. This is most notable in males suffering major trauma (30% in 2019 reducing to 23% in 2020).

Patients aged 0-15 years

• STAG report on 237 children and young people within a paediatric section of the report. 22% of these patients are classified as having major trauma.
• 79% of major trauma paediatric patients are male.
• Falls and moving vehicle accidents account for 75% of all paediatric trauma.

Background

STAG is within the Scottish National Audit Programme which is part of Public Health Scotland. STAG’s aim is to improve the quality of care, patient experience and outcomes through measuring compliance against standards of care to support local quality improvement. Full details of the Key Performance Indicators can be found on the STAG website (external website).

Further information

Please see the STAG website (external website) for more information.

The next release of this publication will be in summer 2022.