4.1 Comparison to previous audit and other trauma centres
When evaluating the care people received, increasing proportions of PNIs were investigated with imaging as outlined in NICE Guidelines (3,7). We compared this treatment with a previous 2009-2011 audit at our trust and found it was most noticeable when comparing patients who received a CT scan (75.8% February 2019 to April 2021 compared to 58.3% December 2009 to May 2011) and CTA/CT with contrast (67.7% February 2019 to April 2021 compared to 8.3 % December 2009 to May 2011).
A rise in DSH pre and post pandemic was noted. A previous 2009-2011 audit of PNIs in our trust revealed 48.0% were attributed to DSH (3), we noted a similar rate in our 2019/2021 audit with 40.7% of PNIs pre-lockdown, however this increased to 66.6% of PNIs post-lockdown, an increase of 177.8% (see Table 1).
The other major cause of PNI, GBH had decreased during lockdown. 40% of total PNIs were attributed to GBH in 2009-2011, compared to 21.6% of PNIs noted after the first lockdown in our audit (3). This corresponds to trends in penetrating trauma at other centres including King’s College Hospital they noted 25% of PNIs were due to PNI compared to 11% in 2019 (8). In 2020, DSH represented 27% of total traumas compared to 11% in 2019 whilst GBH dropped to 63% in 2020 compared to 89% in 2019 (8).