26 Are prehospital deaths from trauma and accidental injury preventable? A summary report Study two Sample characteristics One hundred and thirty-four deaths from the Cheshire data met the inclusion criteria, and forty- four from Manchester (City). While there were significantly more accidental deaths in Cheshire than in Manchester (City) (71.6 per cent vs. 54.5 per cent, p<.05), gender (79 per cent vs 77 per cent male) and age (53.6 years vs. 48.2 years) were comparable. The average age observed in the current study reflects trends in the hospital trauma population, In contrast, fewer deaths were observed as 9 where the average age of death from injury is a result of motor vehicle injury; these deaths 53.8 years (Kehoe et al. 2015). Furthermore, a accounted for 27.6 per cent (n = 37) in Cheshire gender difference is also observed in deaths from and much fewer in Manchester (City) (15.9 per injuries, with a higher proportion of male deaths cent, n = 7). This cause of injury, however, still from injury (1 in 8) than female (1 in 14) (WHO accounts for a sizeable proportion of overall 2008), albeit from a global population. deaths. Time of death The proportion of those who died after a RTC was reversed for the two cohorts. In Cheshire, 45.9 per Table 2 displays the available data related to cent (n = 17) of those deceased following an RTC whether the injured person was: were car occupants, and 29.7 per cent (n = 11) were pedestrians, compared to 29 per cent (n = 2) > found dead, where the injury was not car occupants and 43 per cent (n = 3) pedestrians witnessed, and death was declared in Manchester (City). However, the lower numbers immediately on discovery of the body in Manchester (City) are likely to have shaped this finding. Certainly the Cheshire data are more > dead at the scene, where a bystander were aligned with current statistics for road deaths present at the time of injury or prior to death, or in Great Britain, with car deaths accounting for 44 per cent and pedestrian deaths for 24 per cent > dead on arrival, where death occurred following of road deaths (DfT 2015). transportation from the scene but prior to hospitalisation or when declared within the Overall, this pattern of injury is in line with external emergency department. research, which notes that the most common cause of death from injury has shifted from RTCs Mechanism of injury (59.1 per cent in 1990) to low-level falls (39.1 per cent in 2013) (Kehoe et al. 2015). Significantly more deaths in Cheshire were accidental (p<0.05), and fewer due to assault Calculating the probability of survival (p<0.05), than in Manchester (City). Traumatic brain injury was noted in 76 per cent of Cheshire The average ISS was similar for both cohorts cases, compared to 66 per cent of those in – 38.2 for Cheshire and 36.1 for Manchester Manchester (City). (City). However, 29 Cheshire deaths had an ISS of 75 (the maximum possible and considered not The main mechanism of injury for both Cheshire survivable), compared to 7 in Manchester (City). In and Manchester (City) deaths was falls (39 per addition, 21 Cheshire deaths and 5 Manchester cent and 45 per cent, respectively). Of these falls, (City) deaths had an ISS of less than 15, which the Manchester (City) coroner’s reports reveal a does not qualify as a major trauma. higher proportion of deaths by high-energy falls than in Cheshire (85 per cent and 52 per cent, respectively, p<0.05). 9 Including motor vehicle injury, motorcycle injury, bicycle injury and pedestrian; excluding other traffic (ship, aircraft, train).