OBJECTIVES: Major trauma has been one of leading causes of morbidity, mortality, and functional disability, resulting in substantial societal burden. The aim of this study was to estimate the trend of burden of major trauma in Taiwan during 2003-2015.

METHODS: We defined major trauma as those with an injury severity score (ISS) ≥ 16. All new patients with major trauma were abstracted from National Health Insurance Research Database (NHIRD) in Taiwan from January 2003 to December 2015. We explored the time trends of incidence and mortality rates stratified by age and sex, as well as life expectancy (LE) and loss of life expectancy (or, expected years of life loss, EYLL) compared with age, sex and calendar-year matched referents simulated from vital statistics of Taiwan.

RESULTS: A total of 75,625 cases of major trauma with 30,902 fatality and an estimated loss of 917,467 life-years were found during 2003-2015. For both genders, the incidence rates of those above 65 years old were about 2-3 times higher than all the other age groups. The cumulative incidence rate (CIR_0-79) of major trauma increased profoundly from 2003 to 2015. The case fatality rate was higher in men (41.8%) than female (38.5%). The LE gradually declined with advanced age in both genders, and women had a longer LE than men (21.5 ± 0.8 versus 17.9 ± 0.6 years). The EYLL were all more than 10 years in the age-groups under 65 years old. On average, men had a higher EYLL at 13±0.6 years compared with 10±0.8 years in women.

CONCLUSIONS: There is a consistently increasing trend of cumulative incidence and mortality, especially among elderly people. With Taiwan becoming an aged population (>14%) in 2018, we should tackle this challenge effectively in the coming decades.