Trauma is a leading cause of death and disability in the United States (US). This analysis describes trends and annual changes in in-hospital trauma morbidity and mortality; evaluates changes in age and gender specific outcomes, diagnoses, causes of injury, injury severity and surgical procedures performed; examines the role of teaching hospitals and Level 1 trauma centers in the care of severely injured patients.

Trauma is the leading cause of death for individuals up to the age of 45 years (Table of Causes of Death)

Trauma is the fourth leading cause of death overall for all ages.

There are almost 40,000 homicide and suicide deaths each year in the US.

There were over 30,000 suicides in the US in 2001

Suicide Fact Sheet from the NVIPC at CDC

There were 43,443 deaths and 2.7 million injuries from motor vehicle crashes in the US in 2005. Traffic Safety Facts, 2005 from the NHTSA

Traumatic Brain Injury

Traumatic Brain Injury (TBI) is the single largest cause of death from injury in the United States:

• 1,000,000 people with TBI per year in US:
• 230,00 hospitalized
• 50,000 die (one third of all trauma deaths)
• 80 to 90,000 with long term disability

There are over 5 million people in the US living with disability from TBI at an estimated cost of over $37.8 billion per year.

Fact Sheet from the NVIPC at CDC: http://www.cdc.gov/ncipc/factsheets/tbi.htm

The Toll of Trauma

Traumatic injury takes an extraordinarily heavy toll across our society–it’s the leading cause of death between the ages of 1 and 45, and the #3 cause of death thereafter.

Trauma is not commonly understood as a single disease, making it challenging for the research community to coalesce around a unified approach to the condition and for funding agencies to provide targeted support. Trauma is uniquely defined by the severity and location of the injury—as a bodily wound or shock produced by sudden physical injury, such as that from violence or an accident. Causes of trauma include vehicle crashes, severe falls, bullets, knives, blunt force, blasts and burns.

While the mechanisms of injury vary greatly, the distress to bodily systems, including uncontrolled bleeding, airway obstruction, lung injury, severe tissue damage, vascular injury, broken bones—and all the complications that result from these physical shocks—are part of a constellation of conditions we call trauma.

Despite dramatic improvements in acute trauma care over the last several decades, injury continues to be a major problem. It is well known that clinical research improves patient care and saves lives. While individual trauma research programs have seen some success, there has been no coordinated national effort to unite all the work that is being done to focus on a comprehensive research agenda. Of concern is the impact of injury on long-term outcomes. The NTRAP provides a roadmap for trauma research across the U.S. and a platform for coordinated federal activity supporting the trauma research needed in America.

This coordinated gap analysis and priority formulation effort will advance trauma research in saving lives and improving outcomes for the millions of Americans injured each year—many of whom are unable to return to work and are at higher risk of hospital readmission, depression, or post-traumatic stress disorder.

It is well known that clinical research improves patient care and saves lives. But while individual trauma research programs have seen some success, there has been no coordinated national effort to focus on a comprehensive research agenda, and there remain serious limitations in the diffusion of those gains over time in both the military and civilian sectors.

The NASEM report outlined 11 substantive recommendations toward achieving zero preventable deaths after injury and minimizing trauma-related disability. Among these, recommendations #7 and #8 pertained to the advancement of trauma research.

To address the NASEM report’s research recommendations, CNTR was awarded Department of Defense funding to develop a National Trauma Research Action Plan (NTRAP) that would:

• Identify research priorities across the continuum of care following a gap analysis of military and civilian research.
• Define optimal metrics to assess long-term functional outcomes in injured patients.
• Identify trauma research regulatory barriers, develop best practices for investigators, and define optimal endpoints for clinical trauma research.

The results of this work–the National Trauma Research Action Plan–are available to investigators on this site.