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Each year, the San Diego Emergency Medical Services releases a trauma report summary, detailing instances of trauma in San Diego County. The most recent report, for the year 2016, provides us with a great look at the number of accidents, emergency room visits, and more that took place. The report can help us get a better picture of the state of affairs in San Diego County.
Beginning in 1983, the San Diego County Board of Supervisors set a series of trauma standards that closely followed those used by the American College of Surgeons. Once the board agreed on a set of standards, a task force selected hospitals to become the major trauma centers in the county.
The task force chose five adult trauma centers and one pediatric trauma center, and the county began to route trauma patients to those centers in 1984. Before adoption, the rate of preventable trauma deaths in San Diego County was 21%; in 2016, it was less than 1%. The system is clearly working, and its trauma report details the county’s trauma patient volume, demographics, causes of injury, and outcomes of care.
Between the years 2006 to 2016, the San Diego County Trauma system recorded a 17.5% increase in traumas, with an increase in adult traumas of 22.8%. During the same time frame, the San Diego County population increased by 9.7%. Each of the adult trauma centers experienced growth in volume, with Palomar Medical Center experiencing a 54.3% growth, by far the most. The children’s trauma center at Rady Children’s actually shows a decrease of 8.8%. The overall growth in population accounts for at least a portion of the increase in trauma volume in the county.
In 2016, the younger age groups from 15 to 54 comprised 55.4% of all traumas, with the highest volume coming from the 15 to 24 and 25 to 34 groups, at 2,131 and 1,959 respectively. By contrast, those aged 84+ had only 1,062 instances of trauma, while those 5 to 14 had only 608. However, the total trauma volume for an age group does not give the whole picture. The rate of trauma for patients over 84 is actually 1,705 per 100,000 people, while the 15 to 24 group sits at 445. Clearly, there is a much higher risk of traumatic injury to the elderly population.
For 2016, blunt force trauma outweighed penetrating trauma by more than ten to one. When it comes to the mechanism of injury, however, falls were the number one source of injury for every age group besides those ages 15 to 44, where motor vehicle injuries claimed the number one spot. The majority of the age groups claimed motor vehicle accidents as the second leading cause of injury, while 15 to 44 claimed assault injuries. However, pedestrian injuries had the highest mortality rate, at 5.5%.
The mortality rate in San Diego County has fallen in recent years, as it has ever since the implementation of the new system. 2016 saw only a 2.5% trauma mortality rate. The oldest age groups had the highest mortality rates, increasing across all age groups 15 and up. This is expected; as people age, they are less likely to recover from injury.
Overall, the San Diego County trauma system appears to be highly effective. After treating over 250,000 patients in thirty years, the county states that patients experiencing traumatic injury in San Diego County are twice as likely to survive as they would be anywhere else.