THE DEMOGRAPHICS OF TRAUMA IN 1995 REVISITED - AN ASSESSMENT OF THE ACCURACY AND UTILITY OF TRAUMA PREDICTIONS

Objective: In 1987, the article ''The Demographics of Trauma in 1995'' (DT95) attempted to predict the future needs of trauma centers based on changing population distributions, This article foresaw a relative increase in the number of injuries to the elderly and a relative decre ase in total injuries. Based on these predictions, the paper recommend ed increasing the capabilities of existing trauma centers rather than developing new facilities. We compared these predictions to actual exp erience to validate this use of demographic data in trauma system plan ning. Methods: The predictions of DT95 were compared with the availabl e population and injury data from the U.S. Census Bureau and the Cente rs for Disease Control and Prevention using age-related cohort analysi s. Results: As predicted, the highest-growing segment was the populati on older than 65 years, which increased 18% to 33.5 million. Also, the rate of injury-related deaths per 100,000 decreased from 61.20 in 198 5 to 57.98 in 1995, The number of fatal motor vehicle crashes decrease d from 45,958 in 1985 to 43,484 in 1995, Against predictions, the numb er of firearm deaths in 1994 increased from 31,566 to 35,957, Accurate predictions were thus made for most trauma demographic categories usi ng a combination of census predictions and existing trauma demographic patterns. The increase in firearm deaths, however, was not anticipate d using these sources and suggested the potential development of a mor e violent society. Conclusions: Demographic projections assist in pred icting the number and type of future injuries, Sociologic and economic factors also need to be considered in any predictive determinations o f the true demand for trauma centers.