There has been a gradual aging of the population in European developed countries in the last decades, attributable to factors such as the “Baby Boom” and increased life expectancy. Moreover, there has been a notoriously decrease in workplace and traffic accident rate, attributable to the investment in primary prevention. These circumstances may modify the demography and the profile of trauma patients, creating new challenges to be addressed. The authors intend to describe the profile of the trauma patient admitted at a level-1 Trauma Center in Portugal.

Retrospective study, with review of patient records (n=26 536). Selected all patients admitted with ICD codes related to trauma in 1993–2013. The following variables were described: age, gender, seasonality and mechanism of injury, with distribution according to age group (<18, 18–65, >65 years old [yo]). The authors compared also the variation of these variables between 1993–1997 and 2009–2013. Two particular groups were evaluated: fractures of the proximal femur (typical of the elderly with low-energy mechanism) and fractures of the femoral diaphysis (typical of high energy trauma in the young).

In this period, it was noticed a 15% overall decrease in hospitalisation of trauma patients (−4% in <18 yo, −16% in 18–65 yo, +20% in >65 yo). It was observed a 40% increase in the average age: 38,4 versus 55,3 yo. The male/female ratio changed from 2:1 to 1:1. Before 65 yo, two-third of the patients are males while in the elderly approximately 75% are females. Fifty-five percent of elderly patients sustained fractures of the proximal femur (80% female), it was verified a 50% increase in the incidence of these fractures in this age group and a 20% increase in its age of presentation. Fractures of the femoral diaphysis are more common in male (66%), their incidence decreased by 65%.

In the 20th century, great part of the work conducted in traumatology investigation was focused in the treatment of younger patients suffering high-energy injuries. However, the characteristics of the trauma patient seem to have been changing in the last decades. The authors observed a significant change in the profile of the trauma patient admitted at their hospital, detecting a trend to older patients with injuries resulting from low-energy mechanisms.

This knowledge will allow the adaptation of health care accordingly to this profile, from the instruction of the orthopaedic surgeon to the creation of prevention programmes.