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Japan Trauma Data Bank Report 2012(2007-2011)
The Japanese Association for the Surgery of Trauma
(Trauma Registry Committee)
The Japanese Association for Acute Medicine
(Committee for Clinical Care Evaluation)
Japan Trauma Care and Research
Japan Trauma Data Bank Report 2007-2011Sapporo City General Hospital
Nikko Memorial Hospital
Sapporo Medical University Hospital
Teine Keijinkai Hospital
Hokkaido University Hospital
Hokuto Hospital
Hachinohe City Hospital
Hirosaki University School of Medicine & Hospital
Akita Red Cross Hospital
Iwate Medical University Hospital
Kuji Prefectural Hospital
Osaki Citizen Hospital
Tohoku University Hospital
Sendai City Hospital
Ishinomaki Red Cross Hospital
Ohta Nishinouchi Hospital
Aizu Central Hospital
Tsukuba Medical Center Hospital
Ibaraki Seinan Medical Hospital
Mito Medical Center
University of Tsukuba Hospital
Dokkyo Medical University Hospital
Juntendo University Urayasu Hospital
Chiba University Hospital
Showa University Hospital
Tokyo Metropolitan Hiroo Hospital
Musashino Red Cross Hospital
Tokyo Medical University Hospital
Teikyo University Hospital
National Center for Global Health and Medicine
Tokyo Women’s Medical University Medical Center East
National Disaster Medical Center
Nippon Medical School Hospital
Nippon Medical School Tama Nagayama Hospital
Kyorin University Hospital
Surugadai Nihon University Hospital
Tokyo Women’s Medical University Hospital
Ohme Municipal General Hospital
Nihon University Itabashi Hospital
Tokyo Medical and Dental University Hospital
Tokyo Metropolitan Bokutoh Hospital
Tokyo Medical University Hachioji Medical Center
Keio University Hospital
St.Luke’s International Hospital
Niigata City General Hospital
Kanazawa University Hospital
Toyama Prefectural Central Hospital
Toyama University Hospital
Kouseiren Takaoka Hospital
Tonami General Hospital
Fukui Prefectural Hospital
Yamanashi Prefectural Central Hospital
Saku Central Hospital
Shinshu University Hospital
Aizawa Hospital
Suwa Red Cross Hospital
Iida Municipal Hospital
Chuno Kosei Hospital
Gifu University Hospital
Takayama Red Cross Hospital
Ogaki Municipal Hospital
Numazu City Hospital
Shizuoka Red Cross Hospital
Seirei Mikatahara General Hospital
Shizuoka Children’s Hospital
Shizuoka Saiseikai General Hospital
Figure 1A Names of All Hospitals Submitting Data to the JTDB (N=196, part 1)© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Dokkyo Medical University Hospital
Jichi Medical University Hospital
Saiseikai Utunomiya Hospital
Gunma University Hospital
Maebashi Red Cross Hospital
Takasaki General Medical Center
Saitama Red Cross Hospital
Kawaguchi Municipal Medical Center
Dokkyo Medical University Koshigaya Hospital
National Defense Medical College Hospital
Saitama Medical University Medical Center
Saitama Medical University International Medical Center
Kuki General Hospital
Funabashi Municipal Medical Center
Asahi Central Hospital
Nippon Medical School Chiba Hokusoh Hospital
Chiba Emergency Medical Center
Kameda General Hospital
Kimitsu Chuou Hospital
St.Luke’s International Hospital
Tokyo Medical Center
Toho University Omori Medical Center
Showa University Northern Yokohama Hospital
Yokohama Medical Center
Nippon Medical School Musashikosugi Hospital
Saiseikai Yokohama-city East Hospital
St. Marianna University School of Medicine Hospital
Kanto Rosai Hospital
Yokohama City University Medical Center
Tokai University Hospital
Showa University Fujigaoka Hospital
Kitasato University Hospital
Yokosuka General Hospital Uwamachi
Yokosuka Kyosai Hospital
Yokohama City Minato Red Cross Hospital
Shonan Kamakura General Hospital
Yokohama Municipal Citizens Hospital
Odawara Municipal Hospital
Shizuoka Saiseikai General Hospital
Toyohashi Municipal Hospital
Aichi Medical University Hospital
Nagoya Ekisaikai Hospital
Social Insurance Chukyo Hospital
Okazaki City Hospital
Daiyukai General Hospital
Nagoya City University Hospital
Fujita Health University Hospital
Saiseikai Shigaken Hospital
Omihachiman Community Medical Center
Kyoto Daini Red Cross Hospital
Kyoto Medical Center
Rakuwakai Otowa Hospital
Osaka Prefectural Senshu Critical Medical Care Center
Saiseikai Senri Hospital
Hanwa Memorial Hospital
Osaka Mishima Emergency Medical Center
Kinki University Hospital
Japan Trauma Data Bank Report 2007-2011
Kishiwada Tokushukai Hospital
Osaka University Hospital
Osaka General Medical Center
Kansai Medical University Takii Hospital
Osaka City University Hospital
Osaka General Medical Center
Osaka Medical Center
Nakakawachi Medical Center of Acute Medicine
Kobe University Hospital
Hyogo Emergency Medical CenterToyooka Hospital Tajima Emergency & Critical Care Medical Center
Public Muraoka Hospital
Kansai Rosai Hospital
Hyogo Prefectural Nishinomiya Hospital
Hyogo Prefectural Kakogawa Medical Center
Hyogo Prefectural Awaji Hospital
Hospital of Hyogo College of Medicine
Nara Prefectural Nara Hospital
Nara Medical University Hospital
Mie University Hospital
Wakayama Medical University Hospital
Tsuyama Chuo Hospital
Ehime University Hospital
Kochi Medical Center
Chikamori Hospital
Kurume University Hospital
Iizuka Hospital
Ohtemachi Hospital
Kitakyushu Municipal Yahata Hospital
Kyushu University Hospital
Kitakyushu General Hospital
Kokura Memorial Hospital
Saiseikai Fukuoka General Hospital
Fukuoka University Hospital
St. Maria’s Hospital
Fukuoka Wajiro Hospital
Fukuoka Red Cross Hospital
Saga Prefectural Hospital Koseikan
Saga University Hospital
Arao Municipal Hospital
Kumamoto Red Cross Hospital
Kumamoto Medical Center
Saiseikai Kumamoto Hospital
Nagasaki University Hospital
Nagasaki Medical Center
Figure 1B Names of All Hospitals Submitting Data to the JTDB (N=196, part 2)© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Tsuyama Chuo Hospital
Kawasaki Medical School Hospital
Okayama University Hospital
Hiroshima Prefectural Hospital
Chugoku Rosai Hospital
Hiroshima University Hospital
Kure Medical Center
Fukuyama City Hospital
Yamaguchi University Hospital
Kanmon Medical Center
Tokuyama Central Hospital
Yamaguchi Grand Medical Center
Tottori University Hospital
Tokushima Prefectural Miyoshi Hospital
Tokushima Prefectural Kaifu Hospital
Tokushima Prefectural Central Hospital
Taoka Hospital
Kagawa University Hospital
Kagawa Prefectural Central Hospital
Ehime Prefectural Central Hospital
Nagasaki Medical Center
Oita University Hospital
Miyazaki Prefectural Miyazaki Hospital
Miyazaki University Hospital
Miyazaki Zenjinkai Hospital
Miyakonojo Regional Medical Center
Osumikanoya Hospital
Kagoshima City Hospital
Okinawa Prefectural Chubu Hospital
Urasoe General Hospital
Nakagami Hospital
Okinawa Prefectural Hokubu Hospital
Ryukyu University Hospital
15
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35
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45
Japan Trauma Data Bank Report 2007-2011
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© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Figure 2 Number of Hospitals Submitting to the JTDB by Region.
Japan Trauma Data Bank Report 2007-2011
600
800
1000
1200
1400N
um
ber
of
Pa
tien
ts
Figure3 Number of Patients by Age.
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
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Age (years)
Japan Trauma Data Bank Report 2007-2011
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700
800
Male
Female
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Figure4 Patients by Age and Gender.
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
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Japan Trauma Data Bank Report 2007-2011
Figure 5 Patients by mechanism of injuryTraffic accident includes pedestrian victims.
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© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Table 5Patients by
mechanism ofinjury
Japan Trauma Data Bank Report 2007-2011
Mechanism of injuryPatients
(n)
Patients by
mechanism of
injury (%)
Traffic accident 30219 37.98
Low-height falls 16534 20.78
Falls 16065 20.19
Stab/Cut 2491 3.13
Fire/Burns 2466 3.10
Other blunt/penetrating 2441 3.07 injury
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Other blunt/penetrating
Sports related 1120 1.41
Compression 987 1.24
Machinary 916 1.15
Transport, other 707 0.89
Falling object 656 0.82
Impalement injury 75 0.09
Gunshot 44 0.06
Unspecified 4855 6.10
Total 79576 100.00
Japan Trauma Data Bank Report 2007-2011
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Age (years)
Figure 6 Mechanism of injury by range of age
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
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Japan Trauma Data Bank Report 2007-2011
Range ofAge (yr)
Trafficaccident
(n)
% of totalrange ofage (%)
Falls (n)% of totalrange ofage (%)
Low-heightfalls (n)
% of totalrange ofage (%)
Stab/Cut(n)
% of totalrange ofage (%)
Fire/Burns(n)
% of totalrange ofage (%)
Other blunt/pnetrating
(n)
% of totalrange ofage (%)
0-4 307 1.02 369 2.30 175 1.06 19 0.76 215 8.72 89 3.65
5-9 1000 3.31 425 2.65 195 1.18 18 0.72 43 1.74 75 3.07
10-14 747 2.47 290 1.81 153 0.93 21 0.84 22 0.89 73 2.99
15-19 2875 9.51 452 2.81 70 0.42 61 2.45 43 1.74 108 4.42
20-24 2749 9.10 766 4.77 98 0.59 155 6.22 94 3.81 114 4.67
25-29 1884 6.23 794 4.94 96 0.58 199 7.99 98 3.97 172 7.05
30-34 1704 5.64 858 5.34 133 0.80 179 7.19 116 4.70 143 5.86
35-39 1916 6.34 975 6.07 189 1.14 249 10.00 143 5.80 167 6.84
40-44 1692 5.60 891 5.55 238 1.44 235 9.43 149 6.04 163 6.68
45-49 1597 5.28 836 5.20 243 1.47 221 8.87 137 5.56 152 6.23
Table 6 Mechanism of injury by range of age
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
45-49 1597 5.28 836 5.20 243 1.47 221 8.87 137 5.56 152 6.23
50-54 1532 5.07 935 5.82 452 2.73 183 7.35 140 5.68 135 5.53
55-59 1933 6.40 1337 8.32 615 3.72 213 8.55 178 7.22 180 7.37
60-64 2206 7.30 1526 9.50 918 5.55 211 8.47 211 8.56 176 7.21
65-69 2015 6.67 1468 9.14 1015 6.14 185 7.43 168 6.81 160 6.55
70-74 1974 6.53 1280 7.97 1565 9.47 121 4.86 171 6.93 163 6.68
75-79 1888 6.25 1235 7.69 2341 14.16 104 4.18 170 6.89 139 5.69
80-84 1360 4.50 808 5.03 2952 17.85 63 2.53 202 8.19 115 4.71
85-89 613 2.03 515 3.21 2848 17.23 29 1.16 108 4.38 58 2.38
>=90 179 0.59 256 1.59 2224 13.45 16 0.64 52 2.11 54 2.21
Unspecified 48 0.16 49 0.31 14 0.08 9 0.36 6 0.24 5 0.20
Total 30219 16065 16534 2491 2466 2441
Japan Trauma Data Bank Report 2007-2011
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Figure 7 Deaths by Mechanism of injury
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
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Japan Trauma Data Bank Report 2007-2011
Figure 8 Case Fatality by Age
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Japan Trauma Data Bank Report 2007-2011
Figure 9 Case Fatality by AgeCase fatality at each age category (Case Fatality = number of deaths divided bythe number of patients at each category ×100 by age )
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Japan Trauma Data Bank Report 2007-2011
Figure 10 Case Fatality by AgeCase fatality due to motor vehicle accidents and burns and stub/cut increased with age.
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Number of patients
2000
2500
3000
3500
4000
45004446
2141
Japan Trauma Data Bank Report 2007-2011
Figure 11A Proportional distribution of length from onset to fatality
The category within 1 day after onset includes CPAOA patients. Total number = 8,703
Length from onset to death in days
0
500
1000
1500
within 1day 2-7days 8-28days over 29days unspecified
1061
563 492
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Mechanism of injury
Others
Crush
Transport others
Falling objects
Machinery
Sports
Firearm
Explosive
Stake
unspecified over 29days 8-28days
2-7days within 1day
Japan Trauma Data Bank Report 2007-2011
Figure 11B Proportional distribution of length from onset to fatality,grouped by mechanism of injury Total number = 8,703
Number of patients
0 500 1000 1500 2000
Motor…
Fall
Tumbled
unspecified
Fire / burn
Cut / piece
Others
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Motorvehicle accident
Fall Tumbled unspecified Fire / burn Cut / piece Others Crush
within 1day 1971 1543 83 284 85 142 86 94
2-7days 926 506 242 133 169 37 58 22
8-28days 383 197 224 55 114 17 32 14
over 29days 141 86 164 34 93 12 14 9
unspecified 252 102 25 32 20 9 17 15
Total 3673 2434 738 538 481 217 207 154
Transport others Falling objects Machinery Sports Firearm Explosive Stake Total
Japan Trauma Data Bank Report 2007-2011
Table 11B Proportional distribution of length from onset to fatality,grouped by mechanism of injury Total number = 8,703
Others; Other specified and classifiable
within 1day 98 27 13 6 13 0 1 4446
2-7days 20 9 2 7 4 6 0 2141
8-28days 6 6 6 5 0 2 0 1061
over 29days 1 3 2 3 1 0 0 563
unspecified 10 4 4 0 1 0 1 492
Total 135 49 27 21 19 8 2 8703
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Pro
ba
bil
ity
of
surv
ival(T
RIS
Sm
eth
od)
0.5
1.0
Japan Trauma Data Bank Report 2007-2011
Length from onset to death in hours
Figure 11C Probability of Survival and Length from Onset to Death in Hours
This figure includes trauma-induced CPAOA cases.Total number of patients is 1,804.
Pro
ba
bil
ity
of
surv
ival(T
RIS
Sm
eth
od
0.0
0:00 3:00 6:00 9:00 12:00 15:00 18:00 21:00 0:0024:00
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Mechanism of injury
Fire / burn
Others
Sports
Crush
Machinery
Falling objects
Transport others
Explosive
Stake
Firearm
61,765
37,994
12,437
25,914
22,926
17,709
11,856
2,551
1,100
661
Japan Trauma Data Bank Report 2007-2011
Figure12 Total hospital length of stay by mechanism of Injury
Total hospital length of stayTotal number of patients is 67,464.Total hospital length of stay of patients are 1,804,752 days.
0 100,000 200,000 300,000 400,000 500,000 600,000 700,000 800,000
Motor vehicle accident
Fall
Tumbled
unspecified
Cut / piece
Fire / burn
718,553
400,323
360,350
62,128
68,485
61,765
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Number ofpatients
% of totalpatients
Total hospital LOSin days
Average ofhospital
LOS in days
Motor vehicle accident 26,343 39.05% 718,553 27.28
Fall 14,459 21.43% 400,323 27.69
Tumbled 14,102 20.90% 360,350 25.55
unspecified 2,954 4.38% 62,128 21.03
Cut / piece 2,058 3.05% 68,485 33.28
Fire / burn 1,993 2.95% 61,765 30.99
Others 1,969 2.92% 37,994 19.30
Sports 895 1.33% 12,437 13.90
Japan Trauma Data Bank Report 2007-2011
Table12 Total and average hospital length of stay by mechanism of injury
LOS; length of stay Other; Other specified and classifiable
Crush 855 1.27% 25,914 30.31
Machinery 738 1.09% 22,926 31.07
Falling objects 562 0.83% 17,709 31.51
Transport, others 329 0.49% 11,856 36.04
Exposive 111 0.16% 2,551 22.98
Stake 65 0.10% 1,100 16.92
Firearm 31 0.05% 661 21.32
Total 67,464 1,804,752 26.75
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Mechanism of injuryTotal number of patients is 67,464.Other; Other specified and classifiable
Others
Sports
Crush
Machinery
Falling objects
Transport others
Explosive
Stake
Firearm
Japan Trauma Data Bank Report 2007-2011
Figure 13 Average Hospital length of stay by mechanism of injury
Average of hospital length of stay in days
0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00
Motor vehicle accident
Fall
Tumbled
unspecified
Cut / piece
Fire / burn
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
1-8 (16.8 %:13,339cases)41-75 (4.9 %:3,926 cases)
Unknown (7.1 %:5,615 cases)
Japan Trauma Data Bank Report 2007-2011
9-15 (36.2 %:28,805 cases)16-24 (19.8 %:15,745 cases)
25-40(15.3 %:12,146 cases)
Figure 14 Patients and Injury Severity Score (ISS)
Proportional distribution of patients grouped by categories of the ISS range. Total N=79,576.The number of patients of ISS 9-15 category was the most of all categories.
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
N=79,576
ISS
2000
3000
4000
5000
6000
1-8
9-15
16-24
25-40
41-75
Japan Trauma Data Bank Report 2007-2011
Age (years)
Figure 15 Patients by ISS and AgeNumber of injured patients grouped by ISS range, at each age from 0 to 105.The peaks of the number of patients based on age distribution were seen at 25-44 and55-74 ages of any ISS categories, and at 75-84 ages of ISS 9-15 . Total N=79,576.
0
1000
0
1-4
5-9
10
-14
15
-19
20
-24
25
-34
35
-44
45
-54
55
-64
65
-74
75
-84
85
-
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
0 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85- Unknown Total
1-8 50 314 515 411 1019 1171 1766 1738 1403 1798 1437 1169 515 33 13339
9-15 60 308 708 581 1278 1275 2157 2382 2362 3496 3897 5546 4731 24 28805
16-24 86 195 338 266 747 820 1357 1631 1723 2588 2744 2357 869 24 15745
25-40 24 86 203 180 648 690 1117 1276 1203 1918 2105 1955 715 26 12146
ISSAge
Japan Trauma Data Bank Report 2007-2011
Table 15 Patients by ISS and Age
41-75 3 27 33 47 242 302 488 508 420 623 570 480 161 22 3926
Unknown 36 87 98 105 282 360 559 653 577 791 790 764 395 118 5615
Total 259 1017 1895 1590 4216 4618 7444 8188 7688 11214 11543 12271 7386 247 79576
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Unknown (9.0 %:780 cases)
41-75 (26.0 %:2,263 cases)
9-15 (7.9 %:690 cases)
16-24 (14.4 %:1,255 cases)
1-8 (1.1 %:100 cases)
Japan Trauma Data Bank Report 2007-2011
25-40 (41.5 %:3,615 cases)
Figure 16A Deaths and Injury Severity Score (ISS)
Proportional distribution of deaths grouped by categories of ISS range. Total N=8,703.Deaths in ISS 25-40 category were the highest (3,615 cases: 41.5% of all deaths).
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Ca
seF
ata
lity
(%)
N=8,703
32.6
63.9
32.4
Japan Trauma Data Bank Report 2007-2011
Figure 16B Case Fatality by Injury Severity Score (ISS) Range
Injury Severity Score
Ca
seF
ata
lity
1.0 2.6
8.6
Case fatality grouped by ISS range. (Case fatality = number of deaths divided by the number ofpatients × 100 by ISS range). Case fatality was higher in severe trauma category.
1-8 16-249-15 Unknown25-40 41-75
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
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N=7,898
ISS
300
400
500
600
700
800
900
1-8
9-15
16-24
25-40
41-75
Japan Trauma Data Bank Report 2007-2011
Figure 17 Deaths by ISS and Age
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The peak was seen at elderly ages in ISS 16-24, and the category ISS 25-40 and ISS 41-75has two peaks at young and elderly ages.
Age (years)
0
100
200
0
1-4
5-9
10
-14
15
-19
20
-24
25
-34
35
-44
45
-54
55
-64
65
-74
75
-84
85
-
41-75
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
0 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85- Unknown Total
1-8 0 0 0 0 3 1 5 11 7 13 19 25 16 0 100
9-15 0 5 4 1 10 23 34 41 39 79 113 166 173 2 690
16-24 3 7 7 4 36 52 75 110 117 168 263 278 132 3 1255
25-40 5 15 24 26 135 147 244 336 307 561 701 792 315 7 3615
ISS
Age
Japan Trauma Data Bank Report 2007-2011
Table 17 Deaths by ISS and Age
25-40 5 15 24 26 135 147 244 336 307 561 701 792 315 7 3615
41-75 3 21 14 19 119 141 281 282 243 362 343 307 115 13 2263
Unknown 5 15 10 10 30 57 81 103 92 113 122 98 39 5 780
Total 16 63 59 60 333 421 720 883 805 1296 1561 1666 790 30 8703
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
40
60
80
100
120
140
Total: n=788
Japan Trauma Data Bank Report 2007-2011
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Male: n=471
Female: n=317
0
20
40
0 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85-
Age(years)
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
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Figure18 Deaths by Age and Gender (ISS<=15)Deaths for patients with ISS<=15 for males and females at each age category.
300
400
500
600
700
800
900
1000
Japan Trauma Data Bank Report 2007-2011
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Total: n=7,110
Male: n=4,825
Female: n=2,285
0
100
200
300
0 1-4 5-9 10-
14
15-
19
20-
24
25-
34
35-
44
45-
54
55-
64
65-
74
75-
84
85-
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
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Age(years)
Figure19 Deaths by Age and Gender (ISS>15)Deaths for patients with ISS>15 for males and females at each age category.
300000
400000
500000
600000
700000
800000
Japan Trauma Data Bank Report 2007-2011
27,608
14,99711,334
To
tal
Ho
spit
al
LO
Sin
Da
ys
Total: n=68,353
0
100000
200000
300000
1-8 9-15 16-24 25-40 41-75
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
10,924patients
3,490
Figure 20A Total Hospital LOS and Injury Severity Score (ISS)Proportional distribution of total hospital length of stay for patients, grouped by ISS range.
To
tal
Ho
spit
al
LO
Sin
Da
ys
ISS Range
20
25
30
35
40
Japan Trauma Data Bank Report 2007-2011
133,583days
681,158
27,608
388,569
14,997
364,966
11,334
89,849
3,490
Av
era
ge
Ho
spit
al
LO
Sin
Da
ys
Total: n=68,353
0
5
10
15
1-8 9-15 16-24 25-40 41-75
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
10,9241patients
Figure 20B Average Hospital LOS and Injury Severity ScoreAverage hospital length of stay for each category of ISS range. (Average hospital length ofstay = total hospital length of stay for each ISS range divided by the total number of patients).
Av
era
ge
Ho
spit
al
LO
Sin
Da
ys
ISS Range
Japan Trauma Data Bank Report 2007-2011
0-0.25; 4,135;5.2% 0.25-0.5; 1,674;
2.1%0.5-0.75; 2,381;
3.0%n/a; 22,452;
28.2% 0-0.25
0.25-0.5
0.5-0.75
0.75-1.0
n/a
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
0.75-1.0; 48,934;61.5%
n=79,576
Figure 21 Patients by Probability of Survival (Ps)
Proportional distribution of patients, grouped by each category of Ps. The Ps category(0.75-1.0) accounted for61.5% of all cases. Twenty eight percent of cases were missing at least one variable required to calculate Ps.n/a: not assessed due to missing data.
Japan Trauma Data Bank Report 2007-2011
0-0.1; 2,637;30.3%
n/a; 2,649; 30.4% 0-0.1
0.1-0.2
0.2-0.3
0.3-0.4
0.4-0.5
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
0.1-0.2; 466;5.4%
0.2-0.3; 484;5.6%
0.3-0.4; 217;2.5%
0.4-0.5; 328;3.8%0.5-0.6; 189;
2.2%0.6-0.7; 393;
4.5%
0.7-0.8; 387;4.4%
0.8-0.9; 375;4.3%
0.9-1.0; 578;6.6%
0.4-0.5
0.5-0.6
0.6-0.7
0.7-0.8
0.8-0.9
0.9-1.0
n/a
n=8,703
Figure 22-A Deaths by Probability of survival (Ps)Proportional distribution of deaths, grouped by each category of Ps. The lowest Ps category (0-0.1) accounted for30.3% of all deaths. n/a: not assessed due to missing values.
Japan Trauma Data Bank Report 2007-2011
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Ca
sefa
tali
ty
0-0.1
0.1-0.2
0.2-0.3
0.3-0.4
0.4-0.5
0.5-0.6
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
0
0.1
0.2
Ps
0.6-0.7
0.7-0.8
0.8-0.9
0.9-1.0
n/a
n=69,012Figure 22-B Case Fatality by Probability of Survival (Ps)
Case fatality for each Ps category (Case fatality = the number of deaths divided by the number of patients x 100 for each Pscategory). The lowest Ps category (0-0.1) and the highest Ps category (0.9-1.0) had the highest fatality 93.3% and the lowestfatality 1.5%, respectively. The trend that the fatality would decrease as Ps increased was observed. Cases without outcomewere excluded from this analysis.n/a: not assessed due to missing values.
Japan Trauma Data Bank Report 2007-2011
Figure 23 The number of patients in traffic accidents by types of vehicle and age
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Japan Trauma Data Bank Report 2007-2011
Figure 24 The number of patients in car accident by drivers and passengers and age
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Japan Trauma Data Bank Report 2007-2011
Figure 25 The number of patients in car accident (driver) by gender and age
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Japan Trauma Data Bank Report 2007-2011
Figure 26 The number of patients in car accident (passenger) by gender and age
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
8
10
12
14
16
18
20
30
40
50
60
70
80
Fatality(%)Number of patients
Japan Trauma Data Bank Report 2007-2011
~1011~
1515~
2021~25 26~30 31~35 36~40 41~45 46~50 51~55 56~60 61~65 66~70 71~75 75~80 81~
Number of Deaths 0 0 18 45 36 25 45 36 42 36 53 73 52 59 44 52
Fatality(%) 0 0.0 6.7 6.7 6.8 5.2 8.1 8.1 9.6 7.9 9.4 12.7 12.6 15.5 14.1 17.5
0
2
4
6
0
10
20
Age
Fig.27 Number of Deaths and Fatalities of Motor Vehicular Drivers by Age
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
30
40
50
60
70
80Number of Patients
Japan Trauma Data Bank Report 2007-2011
~1011~
1515~
2021~
2526~
3031~
3536~
4041~
4546~
5051~
5556~
6061~
6566~
7071~
7575~
8081~
Number of Female Deaths 0 0 4 8 2 1 6 4 5 11 10 7 7 12 6 7
Number of Male Deaths 0 0 14 37 34 24 39 32 37 25 43 66 45 47 38 45
0
10
20
Age
Fig. 28 Number of Deaths of Motor Vehicular Drivers by Age and Genders
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Self-inflicted, 5657, 7.3%
Occupant, 4243, 5.5%
Assault, 1472, 1.9%Other, 467, 0.6%
Undetermined, 1685, 2.2%
Japan Trauma Data Bank Report 2007-2011
Unintentional, 63636, 82.5%
Fig. 29 Proportional distribution of registered patients, groped by intent
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Self-inflicted, 1505, 17.6%
Occupant, 395, 4.6%
Assault, 149, 1.7%
Other, 42, 0.5%
Undetermined, 446, 5.2%
Japan Trauma Data Bank Report 2007-2011
Unintentional, 5999, 70.3%
Fig. 30 Proportional distribution of deaths, grouped by intent
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Female Male
Female
Japan Trauma Data Bank Report 2007-2011
24142 persons
35.6 %
Male
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
An age unknown excludes
Figure 31 Gender proportion of Unintentional and Occupant
Male
43629 persons
64.4 %
Male
Female
Japan Trauma Data Bank Report 2007-2011
Nu
mb
erof
Pati
ents
3000
4000
5000
6000
7000
Female
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Nu
mb
erof
Pati
ents
Age (years)
0
1000
2000
<1 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85-
Unintentional and Occupant by Age and GenderFigure 32
Japan Trauma Data Bank Report 2007-2011
Age Male Female total
< 1 146 84 230
1‐ 4 595 345 940
5‐ 9 1300 521 1821
10‐14 1111 337 1448
15‐19 2824 821 3645
20‐24 2905 803 3708
25‐34 4557 1092 5649
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
35‐44 5064 1188 6252
45‐54 4824 1417 6241
55‐64 6801 2776 9577
65‐74 6265 3881 10146
75‐84 5305 5931 11236
85‐ 1932 4946 6878
43629 24142 67771
Unintentional and Occupant by Age and GenderTable 32
Japan Trauma Data Bank Report 2007-2011
Male
Female
Nu
mb
erof
Pati
ents
100
150
200
250
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Female
Nu
mb
erof
Pati
ents
Age (years)
0
50
100
<1 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85-
Assault by Age and GenderFigure 33
Age Male Female total
< 1 6 2 8
1‐ 4 13 6 19
5‐ 9 13 8 21
10‐14 20 4 24
15‐19 81 14 95
20‐24 93 22 115
25‐34 191 51 242
Japan Trauma Data Bank Report 2007-2011
35‐44 239 63 302
45‐54 175 42 217
55‐64 184 37 221
65‐74 92 36 128
75‐84 33 29 62
85‐ 5 9 14
1145 323 1468
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Table 33 Assault by Age and Gender
Nu
mb
erof
Pati
ents
Japan Trauma Data Bank Report 2007-2011
150
200
250
300
350
400Female
Male
Figure 34 Self-inflicted by Age and Gender
Nu
mb
erof
Pati
ents
Age (years)
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
0
50
100
150
0- 10- 20- 30- 40- 50- 60- 70- 80- 90-
Japan Trauma Data Bank Report 2007-2011
Age 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75- 80- 85- 90- 95-unkno
wntotal
female 1 0 36 188 339 295 296 320 251 189 149 134 146 125 84 51 41 23 8 5 14 2695
Male 1 6 24 118 247 280 284 304 272 233 204 238 231 186 118 104 57 17 19 1 19 2963
total 2 6 60 306 586 575 580 624 523 422 353 372 377 311 202 155 98 40 27 6 33 5658
Table 34 Self-inflicted by Age and Gender
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Japan Trauma Data Bank Report 2007-2011
Tota
lH
osp
ital
LO
Sin
Day
s1485288
600000
800000
1000000
1200000
1400000
1600000
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Tota
lH
osp
ital
LO
Sin
Day
s
Figure 35A Total Hospital LOS by IntentIndustrial accident was included in the category of “Unintentional”.
135778
17634 30651 8968 255970
200000
400000
Unintentional Self-inflicted Assault Undetermined Other Unknown
Aver
age
Hosp
ital
LO
Sin
Day
s
Japan Trauma Data Bank Report 2007-2011
Aver
age
Hosp
ital
LO
Sin
Day
s24.9
28.2
13.9
21.7
24.2
20.4
10
15
20
25
30
Figure 35B Average Hospital LOS by IntentAverage hospital length of stay in days = total hospital length of stay dividedby the number of patients by intent.
Aver
age
Hosp
ital
LO
Sin
Day
s
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Aver
age
Hosp
ital
LO
Sin
Day
s
0
5
10
Unintentional Self-inflicted Assault Undetermined Other Unknown
Japan Trauma Data Bank Report 2007-2011
29,876
12,381
21,140
9,186
12,713
17,528
31,209
10,000
15,000
20,000
25,000
30,000
35,000N
um
be
ro
fp
atie
nts
Figure 36 Number of Patients with Injured Body Parts based on AIS
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
1,128
9,186
6,104
0
5,000
10,000
Hea
d
Face
Nec
k
Tho
rax
Ab
do
men
/Pe
lvic
con
ten
ts
Spin
e
Up
per
extr
emit
ies
Low
erex
trem
itie
s
Skin
/B
urn
s/
Oth
ertr
aum
a
Japan Trauma Data Bank Report 2007-2011
maxAIS 13,938
maxAIS 23,180
maxAIS 55,550
maxAIS 6291
Unknown155
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Figure 37A Head Injury and max AIS Score
maxAIS 38,544
maxAIS 48,218
Japan Trauma Data Bank Report 2007-2011
maxAIS 2
maxAIS 3534
maxAIS 487
Unknown24
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Figure 37B Facial Injury and max AIS Score
maxAIS 17,190
maxAIS 24,546
Japan Trauma Data Bank Report 2007-2011
maxAIS 1500
maxAIS 459
maxAIS 520
Unknown77
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Figure 37C Neck Injury and max AIS Score
500
maxAIS 2232
maxAIS 3240
Japan Trauma Data Bank Report 2007-2011
maxAIS 11,900
maxAIS 21,553
maxAIS 4
maxAIS 52,093
maxAIS 6309
Unknown211
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
Figure 37D Thoracic Injury and max AIS Score
maxAIS 38,743
maxAIS 46,331
Japan Trauma Data Bank Report 2007-2011
maxAIS 11,302
maxAIS 41,323
maxAIS 5339
maxAIS 612
Unknown82
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
maxAIS 23,201
maxAIS 32,927
Figure 37E Injury of Abdomen/Pelvic Contents and max AIS Score
Japan Trauma Data Bank Report 2007-2011
maxAIS 1878
maxAIS 42,189
maxAIS 5834
maxAIS 6214
Unknown57
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
maxAIS 25,398
maxAIS 33,143
Figure 37F Spinal Injury and max AIS Score
Japan Trauma Data Bank Report 2007-2011
maxAIS 14,379
maxAIS 34,019
Unknown4
Figure 37G Injury of Upper Extremities and max AIS Score
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
maxAIS 29,126
Japan Trauma Data Bank Report 2007-2011
maxAIS 13,895
maxAIS 2
maxAIS 41,422
maxAIS 51,271
Unknown17
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
maxAIS 26,768
maxAIS 317,836
Figure 37H Injury of Lower Extremities and max AIS Score
Japan Trauma Data Bank Report 2007-2011
maxAIS 3560
maxAIS 4312
maxAIS 5516
maxAIS 686
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
maxAIS 14,174
maxAIS 2456
Figure 37I Skin/Burns/Other Trauma and max AIS Score
Japan Trauma Data Bank Report 2007-2011
15,000
20,000
25,000
30,000
35,000
40,000 37,929
17,481
Nu
mb
ero
fP
ati
ents
© Japan Trauma Care and Research 2012. All Rights Reserved Worldwide
0
5,000
10,000
15,00010,879
5,229
2,038569 82 2
123456789
Figure 38 Number of Patients and Injured Body Parts based on AIS
Number of injury body parts based on AIS region
Nu
mb
ero
fP
ati
ents
JAPAN TRAUMA DATA BANKREPORT 2012 (2007-2011)
The Japanese Association for Acute Medicine
Chairman: Kaoru Koike, MD
The Japanese Association for the Surgery of Trauma
Chairman: Tetsuya Sakamoto, MD
Task Force: Noriaki Aoki, MD
Masato Ueno, MD
Yasuyuki Uchida, MD
December 15, 2012
Yasuyuki Uchida, MD
Jun Oda, MD
Akio Kimura, MD
Daizoh Saitoh, MD
Yuichiro Sakamoto, MD
Keiji Tanaka, MD
Hideo Tohira, MD
Shinji Nakahara, MD
Munetaka Hayashi, MD
Atsuhiro Fukuda, MD
Tomohiko Masuno, MD
Yoshihiro Yamaguchi, MD