24 Are prehospital deaths from trauma and accidental injury preventable? A summary report Study one collisions (RTCs)7 in the present study (27.6 per cent, n = 37) than previously (56.6 per cent, n Sample characteristics = 86), though it is clear that this cause of injury still accounts for a sizeable proportion of overall One hundred and thirty-four deaths met the deaths. The proportion of those who died after the inclusion criteria, which is slightly fewer than the RTC was similar for both studies: 45.9 per cent 1994 study (n = 152). (n = 17) car occupants vs. 43.0 per cent (n = 37) previously, and 29.7 per cent (n = 11) pedestrians While gender was broadly comparable between vs. 25.6 per cent (n = 22) previously. This is similar both studies (110 male and 42 female vs. to current statistics for road deaths in Great 106 male and 28 female in the previous study), Britain, with car deaths accounting for 44 per cent the current sample was older than in the original and pedestrian deaths for 24 per cent of road study, with a mean age of 53.6 years compared deaths (DfT 2015). to 41.9 years. However, these trends are in line with existing research, where the average age of In contrast to the decrease in the number of death from injury increased from 36.1 years in RTCs, the number of falls was observed to have 1990 to 53.8 years in 2013 (Kehoe et al. 2015). increased as a main mechanism of injury in the Furthermore, a gender difference is also observed present study (38.8 per cent, n = 52 vs. 15.1 per in the proportion of deaths from injuries, with cent, n = 23). Of these falls, 48.1 per cent (n = 25) a higher proportion of male deaths from injury were as a result of a low-energy fall (at the same (1 in 8) than female (1 in 14) (WHO 2008). level) and 51.9 per cent (n = 27) a high-energy fall (above body height). This increase in the number Time of death of falls is in line with findings from Kehoe et al. (2015) that show that the most common cause Table 1 displays the available data related to of injury has shifted from RTCs (59.1 per cent in whether the injured person was found dead, dead 1990) to low-level falls (39.1 per cent in 2013). at the scene or dead on arrival: Deaths from falls were analysed further, and it > 46.3 per cent (n = 62) of the injured were found was observed that this cohort was more likely to dead, where the injury was not witnessed, and be male (36 male vs. 16 female) and older, with death was declared immediately on discovery an average age of the deceased at 64.7 years of the body (interquartile range 46 to 82). In 88.5 per cent of cases, the fall was accidental. > 43.3 per cent (n = 58) were dead at the scene, where bystanders were present at the time of Based on the coroner’s records, being found dead injury or prior to death after a fall was more frequently observed than dead at the scene or dead on arrival – 71.2 per 10.4 per cent (n = 14) were dead on arrival, where cent, 23 per cent and 5.7 per cent, respectively. death occurred following transportation from the Of the 12 who were dead at the scene, all but one scene but prior to hospitalisation or when declared had either a bystander present or there within a within the emergency department. minute, and the three who were dead on arrival at hospital all had a bystander present immediately or Mechanism of injury within minutes. The majority of deaths in the current study were as Of those found dead, 22 of the 37 were aged a result of accidental (unintentional) injury (71.6 per 71 years or over, and none of the 22 had a cent, n = 96). There were fewer road traffic bystander or passer-by present within hours. Table 1. Status of injured person on discovery It is noteworthy that significantly more hangings were observed in the current study than in 1994. Cheshire The proportion of hangings rose from 9 per cent % (number) (n = 30) of the original study sample to 25 per cent Found dead (n = 139) in this present study (p<.05). 46 (62) Dead at the scene 43 (58) Dead on arrival 10 (14) 7 Including motor vehicle injury, motorcycle injury, bicycle injury and Note: Some figures are rounded down pedestrian; excluding other traffic (ship, aircraft, train).