Epidemiological trends in abdominal trauma in Norway (2015–2023): a national register-based cohort study of severity, population-adjusted incidence, and short-term outcomes

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Background: Published data describing epidemiological trends of abdominal injury on a national level are scarce. This study aims to analyse trends in demographics, severity, population-adjusted incidences, and short-term outcomes of abdominal trauma based on national trauma register data. Methods: Observational, complete national cohort study of all consecutive traumatic incidents resulting in abdominal injuries reported to the National Trauma Register (NTR) of Norway between 2015 and 2023. The NTR has demonstrated an overall coverage rate of 92.2% of trauma patients, with excellent data accuracy. Standardised incidence rates were estimated using the direct method with standard populations. Temporal trends were evaluated in regression models. Findings: Abdominal injuries occurred in 9.0% (7086/78,416) of all registered traumatic incidents. Children represented 18.1% (n = 1275) of the patients, and 14.8% (n = 1047) were elderly. The median age was 35 years (interquartile range, IQR: 19-55) and increased by 0.4 years annually (95% confidence interval, CI: 0.0-0.8). Men accounted for 69.5% (n = 4926) and 30.5% (n = 2160) were female. Blunt injury type dominated with 85.3% (n = 6044). Traffic-related accidents were the most common mechanism (48.0%, n = 3401), followed by falls (26.9%, n = 1903). The median Injury Severity Score (ISS) was 10 (IQR 2-18), and 36.3% (n = 2567) displayed ISS>15 indicating severe injury. Polytrauma occurred in 20.6% (n = 1457) of trauma cases suffering abdominal injury. Age- and sex-adjusted incidence of all abdominal injuries was 14.9/100,000/year (95% CI: 14.5-15.3). The annual increase was 0.43 per 100,000 person-years (95% CI: 0.14-0.71) among children and 0.68 per 100,000 person-years (95% CI: 0.39-0.97) for elderly patients. The subgroup of solid organ injuries showed an adjusted incidence of 7.2/100,000/year (95% CI: 7.0-7.5), and hollow viscus injuries of 1.2/100,000/year (95% CI: 1.1-1.3). Overall 30-day mortality was 3.4% (n = 240), with no statistically significant change during the study period. Interpretation: Trauma patients presenting with abdominal injury are getting older. One third sustained severe injuries and one in five patients suffered polytraumatic injuries. The incidence of abdominal trauma increased over the last decade, predominantly amongst elderly patients and children. The mortality was low, and stable over time. Funding: None.

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