Case Fatality (% ) Injury Severity Score

Japan Trauma Data Bank Report 2020 (2019.1 – 2019.12)

Japan Trauma Care and Research

The Japanese Association for the Surgery of Trauma (Trauma Registry Committee) The Japanese Association for Acute Medicine (Committee for Clinical Care Evaluation)

© Japan Trauma Care and Research 2020. All Rights Reserved Worldwide Japan Trauma Data Bank Report 2020 Figure 1A Names of all hospitals submitting data to the JTDB. (N=288, Part 1) Sapporo City General Hospital Ota Memorial Hospital St. Luke’s International Hospital Nikko Memorial Hospital Saitama Red Cross Hospital Toho University Omori Medical Center Sapporo Medical University Hospital Kawaguchi Municipal Medical Center University of Tokyo Hospital Teine Keijinkai Hospital Dokkyo Medical University Koshigaya Hospital Showa General Hospital Hokkaido University Hospital National Defense Medical College Hospital Tokyo Saiseikai Central Hospital Hokuto Hospital Saitama Medical University Medical Center National Center for Child Health and Development Hokkaido Medical Center Saitama Medical University International Medical Center Shirahigebashi Hospital Asahikawa Red Cross Hospital Kuki General Hospital Japanese Red Cross Medical Center Sapporo Tokushukai Hospital Fukaya Red Cross Hospital Tokyo Metropolitan Tama Medical Center Hakodate Municipal Hospital Jichi Medical University Saitama Medical Center Kokushikan University Sapporo Higashi Tokushukai Hospital Saitama City Hospital Juntendo University Nerima Hospital Kushiro City General Hospital Funabashi Municipal Medical Center Showa University Northern Yokohama Hospital Hachinohe City Hospital Asahi General Hospital Yokohama Medical Center Hirosaki University School of Medicine & Hospital Nippon Medical School Chiba Hokusoh Hospital St. Marianna University School of Medicine Hospital Aomori Prefectural Central Hospital Chiba Emergency Medical Center Kanto Rosai Hospital Iwate Medical University Hospital Kameda General Hospital Yokohama City University Medical Center Iwate Prefectural Kuji Hospital Kimitsu Chuou Hospital Tokai University Hospital Iwate Prefectural Central Hospital Juntendo University Urayasu Hospital Showa University Fujigaoka Hospital Osaki Citizen Hospital Chiba University Hospital Kitasato University Hospital Tohoku University Hospital Matsudo City General Hospital Yokosuka General Hospital Uwamachi Sendai City Hospital Jikei University Kashiwa Hospital Yokohama City Minato Red Cross Hospital Ishinomaki Red Cross Hospital Tokyo Women’s Medical University Yachiyo Medical Nippon Medical School Musashikosugi Hospital Center Sendai Medical Center Saiseikai Yokohama-city East Hospital Tokyo Bay Urayasu Ichikawa Medical Center South Miyagi Medical Center Shonan Kamakura General Hospital Chiba Rosai Hospital Akita Red Cross Hospital Yokohama Municipal Citizens Hospital Eastern Chiba Medical Center Akita University Hospital Odawara Municipal Hospital Showa University Hospital Yamagata Prefectural Central Hospital Yokosuka Kyosai Hospital Tokyo Medical Center Nihonkai General Hospital Hiratsuka City Hospital Department of Social Medicine, School of Medicine, Nihon Ohta Nishinouchi Hospital Fujisawa City Hospital University Aizu Central Hospital Yokohama Rosai Hospital National Disaster Medical Center Fukushima Medical University Hospital Yokohama Sakae Kyosai Hospital Musashino Red Cross Hospital Niigata City General Hospital Shin-Yurigaoka General Hospital Nippon Medical School Tama Nagayama Hospital Niigata University Medical & Dental Hospital Ebina General Hospital Teikyo University Hospital Niigata Prefectural Shibata Hospital Kawasaki Municipal Hospital National Center for Global Health and Medicine Uonuma Kikan Hospital Saiseikai Yokohama-shi Nanbu Hospital Tokyo Women’s Medical University Medical Center East Tsukuba Medical Center Hospital Yamanashi Prefectural Central Hospital Nippon Medical School Hospital Ibaraki Seinan Medical Hospital Saku Central Hospital Advanced Care Center Kyorin University Hospital Mito Medical Center Shinshu University Hospital Surugadai Nihon University Hospital University of Tsukuba Hospital Aizawa Hospital Tokyo Women’s Medical University Hospital Ibaraki Prefectural Central Hospital Suwa Red Cross Hospital Ohme Municipal General Hospital Mito Saiseikai General Hospital Iida Municipal Hospital Nihon University Itabashi Hospital Dokkyo Medical University Hospital Ina Central Hospital Tokyo Medical and Dental University Hospital Jichi Medical University Hospital Nagano Red Cross Hospital Tokyo Metropolitan Bokutoh Hospital Saiseikai Utunomiya Hospital Nagano Municipal Hospital Tokyo Metropolitan Hiroo Hospital Gunma University Hospital Chuno Kosei Hospital Tokyo Medical University Hospital Maebashi Red Cross Hospital Gifu University Hospital Tokyo Medical University Hachioji Medical Center Takasaki General Medical Center Takayama Red Cross Hospital Keio University Hospital © Japan Trauma Care and Research 2020. All Rights Reserved Worldwide Japan Trauma Data Bank Report 2020 Figure 1B Names of all hospitals submitting data to the JTDB. (N=288, Part 2) Ogaki Municipal Hospital Kyoto Prefectural University of Medicine Kurashiki Central Hospital Gero City Kanayama Hospital Kyoto Okamoto Memorial Hospital Hiroshima Prefectural Hospital Seirei Mikatahara General Hospital Kyoto University Hospital Chugoku Rosai Hospital Numazu City Hospital Rinku General Medical Center Hiroshima University Hospital Shizuoka Red Cross Hospital Osaka Mishima Emergency Medical Center Kure Medical Center Shizuoka Saiseikai General Hospital Kinki University Hospital Fukuyama City Hospital Juntendo University Shizuoka Hospital Kishiwada Tokushukai Hospital Yamaguchi University Hospital Shizuoka General Hospital Osaka University Hospital Kanmon Medical Center Shizuoka Tokushukai Hospital Osaka City General Hospital Tokuyama Central Hospital Chutoen General Medical Center Kansai Medical University Takii Hospital Yamaguchi Grand Medical Center Fujieda Municipal General Hospital Osaka City University Hospital Tokushima Prefectural Miyoshi Hospital Hamamatsu University Hospital Tokushima Prefectural Kaifu Hospital Seirei Hamatsu General Hospital Saiseikai Senri Hospital Aichi Medical University Hospital Osaka General Medical Center Tokushima Prefectural Central Hospital Nagoya Ekisaikai Hospital Osaka Medical Center Taoka Hospital Social Insurance Chukyo Hospital Nakakawachi Medical Center of Acute Medicine Tokushima Red Cross Hospital Okazaki City Hospital Kansai Medical University Hirakata Hospital Kagawa University Hospital Toyohashi Municipal Hospital Sakai City Medical Center Kagawa Prefectural Central Hospital Daiyukai General Hospital Osaka Police Hospital Ehime Prefectural Central Hospital Fujita Health University Hospital Osaka Red Cross Hospital Ehime University Hospital Nagoya City University Hospital Kobe University Hospital Ehime Prefectural Niihama Hospital Handa City Hospital Hyogo Emergency Medical Center Kochi Medical Center Kasugai Municipal Hospital Toyooka Hospital Chikamori Hospital Komaki City Hospital Tajima Emergency & Critical Care Medical Center Kochi Red Cross Hospital Nagoya Medical Hospital Public Muraoka Hospital Kitakyushu General Hospital Japanese Red Cross Nagoya Daini Hospital Kansai Rosai Hospital Kokura Memorial Hospital Ichinomiya Municipal Hospital Hyogo Prefectural Nishinomiya Hospital Saiseikai Fukuoka General Hospital Mie University Hospital Hyogo Prefectural Kakogawa Medical Center Fukuoka University Hospital Mie Perfectural General Medical Center Hyogo Prefectural Awaji Hospital St. Maria’s Hospital Toyama Prefectural Central Hospital Hospital of Hyogo College of Medicine Kurume University Hospital Toyama University Hospital Kobe City Medical Center General Hospital Iizuka Hospital Kouseiren Takaoka Hospital Steel Memorial Hirohata Hospital Ohtemachi Hospital Tonami General Hospital Himeji Emergency, Trauma and Critical Center Kitakyushu Municipal Yahata Hospital Ishikawa Prefectural Central Hospital Nara Prefectural General Medical Center Kyushu University Hospital Fukui Prefectural Hospital Nara Medical University Hospital Fukuoka Wajiro Hospital University of Fukui Hospital Kindai University Nara Hospital Fukuoka Red Cross Hospital Omihachiman Community Medical Center Wakayama Medical University Hospital Fukuoka Higashi Medical Center Saiseikai Shigaken Hospital Japanese Red Cross Wakayama Medical Center Shinyukuhashi Hospital Kyoto Daini Red Cross Hospital Tottori University Hospital Kyushu Medical Center Kyoto Medical Center Shimane University Hospital Saga-ken Medical Center Koseikan Rakuwakai Otowa Hospital Shimane Prefectural Central Hospital Saga University Hospital Fukuchiyama City Hospital Okayama University Hospital Ureshino Medical Center Kyoto Daiichi Red Cross Hospital Tsuyama Chuo Hospital Nagasaki Medical Center Uji-Tokushukai Medical Center Kawasaki Medical School Hospital Nagasaki University Hospital © Japan Trauma Care and Research 2020. All Rights Reserved Worldwide Japan Trauma Data Bank Report 2020 Figure 1C Names of all hospitals submitting data to the JTDB. (N=288, Part 3)

Arao Municipal Hospital Kumamoto Red Cross Hospital Kumamoto Medical Center Saiseikai Kumamoto Hospital Oita University Hospital Almeida Memorial Hospital Miyazaki Prefectural Miyazaki Hospital Miyazaki University Hospital Miyazaki Zenjinkai Hospital Miyakonojo Regional Medical Center Osumikanoya Hospital Kagoshima City Hospital Yonemori Hospital Urasoe General Hospital Nakagami Hospital Okinawa Prefectural Chubu Hospital Okinawa Prefectural Hokubu Hospital Ryukyu University Hospital Tomishiro Central Hospital Okinawa Prefectural Nanbu Medical Center / Nanbu Child Medical Center

Figure

2 Number of hospitals submitting to the JTDB by region. Number of Hospitals of Number

Region

Figure 3 Number of patients by age.

600

500

400 Number of Patientsof Number 300

200

100

Figure 4 Patients by age and gender.

350 Male 300 Female 250

200 Number of Patientsof Number 150

100

0 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 1001 05

Figure 5 Patients by mechanism of injury

Table 5 Patients by mechanism of injury

Figure 6 Mechanism of injury by age

Figure 7 Death by mechanism of injury

Figure 8 Case fatality by age

6 Fatality [%] Fatality

4 Case

0 <1 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85-94 95< Age [year] Case fatality at each age category (Case Fatality=number of deaths divided by the number of patients at each category x 100 by age)

Figure 9 Case fatality by age and gender

45 Male 40 Female 35

25 [%]

CaseFatality 10

0 <1 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85-94 95< Age [year]

Figure 10 Case fatality by mechanism of injury and age

Motor vehicle Railroad Machine Fall and tumble People and things Crush Explosion Gun shot Burn Other 120.00

100.00

80.00

60.00 Case Fatality [%] Fatality Case 40.00

20.00

0.00 <1 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85-94 95< Age [Year]

Figure 11A Proportional distribution of hospitalized days in death cases n =1,896

800 700 600 500

Number of patients 400 300 200 100 0 within 1 day 1-7 days 8-28days over 29 days unspecified

The category within 1 day includes CPAOA patients.

Figure Proportional distribution of hospitalized days, 11B grouped by mechanism of injury n =1,896 Mechanism of injury Motor vehicle and traffic

Overrun or contact with the train

Machinary

Fall

Fall flom stairs etc.

Tumbled

External force（blunt）

External force（sharp） Stake within 1 day Crush

Explosive（blunt） 1-7days Explosive（sharp） 8-28days Firearm over 29days Burn

Landslide, Natural disaster unspecified

unspecified

0 50 100 150 200 250 ・Motor vehicle and traffic; Motor vehicle including pedal cyclist and pedestrian victims, 人 and other traffic vehicle. ・Stake, only one patient was incleded “unspecified. © Japan Trauma Care and Research 2020. All Rights Reserved Worldwide Japan Trauma Data Bank Report 2020

Table Proportional distribution of hospitalized days, grouped by mechanism of injury. 12 n =21,385

Motor Overrun or External External vehicle contact Fall from Machinery Fall Tumbled force force and with the stairs etc. （blunt）（sharp） traffic train Within 1 day 423 30 23 205 125 191 103 47 1～7 days 1876 6 110 37 834 1476 292 180 8～28 days 2194 11 146 15 485 4062 280 159 Over 29 days 1625 17 94 6 523 1676 102 76 unspecified 289 6 6 92 134 168 42 29 total 6407 70 379 327 1671 7573 819 491

Explosive Explosive Landslide, Stake Crush Firearm Burn Natural disaster total （blunt）（sharp） etc.

Within 1 day 3 15 0 0 0 49 44 1258 1～7 days 17 28 1 0 1 135 89 5369 8～28 days 11 61 4 0 2 129 89 8870 Over 29 days 4 67 1 0 0 131 48 5069 unspecified 3 11 0 0 0 24 35 819 total 38 182 6 0 3 468 305 21385

Figure Total hospital length of stay by mechanism of Injury n = 20,777 13A Over all total hospital length of stay was 44,139 days.

Mechanism of injury

Motor vehicle and traffic Overrun or contact with the train Machinary Fall Fall flom stairs etc. Tumbled External force（blunt） External force（sharp） Stake Crush Explosive（blunt） Firearm Burn Total hospital Landslide, Natural disaster length of stay unspecified in days 0 40000 80000 120000 160000

Figure 13B Average hospital length of stay by mechanism of injury n = 20,777 Mechanism of injury

Motor vehicle and traffic 21.63 Overrun or contact with the… 23.94 Machinary 21.73 Fall 25.77 Fall flom stairs etc. 20.72 Tumbled 21.07 External force（blunt） 13.92 External force（sharp） 15.28 Stake 12.34 Crush 33.39 Explosive（blunt） 19.5 Firearm 12.67 Burn 25.62 Landslide, Natural disaster 15.14 0 10 20 30 40 Average of hospital LOS in days "hospitalization within 1 day" is set as "0", the average length of hospitalization may be underestimated.

Table 13 Total and average hospital length of stay by mechanism of injury n = 20,777 Total hospital LOS Average of hospital Mechanism of injury Number of patients / % in days LOS in days Motor vehicle and traffic 6,118 29.45 132,344 21.63 Overrun or contact with the train 64 0.31 1,532 23.94 Machinery 373 1.80 8,107 21.73 Fall 1,537 7.40 39,616 25.77 Fall from stairs etc. 2,901 13.96 60,121 20.72 tumbled 7,405 35.64 156,056 21.07 External force（blunt） 777 3.74 10,812 13.92 External force（sharp） 462 2.22 7,061 15.28 Stake 35 0.17 432 12.34 Crush 171 0.82 5709 33.39 Explosive（blunt） 6 0.03 117 19.50 Explosive（sharp） 0 0.00 0 0.00 Firearm 3 0.01 38 12.67 Burn 444 2.14 11,377 25.62 Landslide, Natural disaster etc. 270 1.30 4,087 15.14 unspecified 211 1.02 3,982 18.87 total 20,777 100% 4,049,382 23.81 "hospitalization within 1 day" is set as "0", the average length of hospitalization may be underestimated. © Japan Trauma Care and Research 2020. All Rights Reserved Worldwide Japan Trauma Data Bank Report 2020

Figure 14 Patients and Injury Severity Score (ISS)

N= 22,089

1162, 5.3% 475, 2.2% 4440, 20.1% ISS 2367, 10.7%

1-8 9-15 16-24 3672, 16.6% 25-40 41-75 Unknown

9973, 45.1%

Figure 15 Patients by ISS and age N= 20,917 3000

2500

2000

1500

1000 Number Patients of Number

500

Age（years）

ISS 1-8 9-15 16-24 25-40 41-75

Table 15 Patients by ISS and age

Age 0 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85- Unknown Total ISS

1-8 24 98 192 143 246 259 380 354 545 465 637 681 413 3 4440

9-15 33 64 106 77 222 250 368 453 762 940 1553 2372 2769 4 9973

16-24 18 24 38 35 122 104 186 245 392 453 795 806 452 2 3672

25-40 9 16 16 22 76 94 123 151 242 267 450 550 350 1 2367

41-75 0 1 2 6 27 34 34 39 78 47 92 77 38 0 475

Unknown 1 9 20 28 74 56 63 97 147 131 200 213 122 1 1162

Total 85 212 374 311 767 797 1154 1339 2166 2303 3727 4699 4144 11 22089

Figure 16A Deaths and Injury Severity Score (ISS)

N= 1,895 159, 8.4% 45, 2.4%

297, 15.7% 279, 14.7% ISS 1-8 9-15 16-24 316, 16.7% 25-40 41-75 Unknown

799, 42.2%

Figure 16B Case fatality by Injury Severity Score (ISS) range

N= 1,895 70 58.7 60

50 (%) 40 33.8 30

Case Case Fatality 20 13.7 8.6 10 3.0 1.0 0 1-8 9-15 16-24 25-40 41-75 Unknown Injury Severity Score

Figure 17 Deaths by ISS and age

N= 1,735 250

200

150

100 Number of Patients Number 50

Age（years）

ISS 1-8 9-15 16-24 25-40 41-75

Table 17 Deaths by ISS and age

Age 0 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85- Unknown Total ISS

1-8 0 1 0 0 1 0 1 1 4 3 6 14 14 0 45

9-15 0 0 0 1 7 8 8 8 8 21 42 85 109 0 297

16-24 1 2 1 4 3 11 7 20 36 35 59 77 60 0 316

25-40 0 4 2 6 12 29 38 50 70 71 152 200 164 1 799

41-75 0 0 2 2 12 22 21 21 50 26 50 47 26 0 279

Unknown 0 1 0 2 4 10 18 16 18 15 19 39 16 1 159

Total 1 8 5 15 39 80 93 116 186 171 328 462 389 2 1895

Figure 18 Deaths by age and gender (ISS<=15)

Female N=6461 50 Male N=7770 40

30 Number of Deaths 20

0 0 1–4 5–9 10–14 15–19 20–24 25–34 35–44 45–54 55–64 65–74 75–84 85– ■Female ■Male Age (Years) Deaths for patients with ISS<=15 for males and females at each age category. © Japan Trauma Care and Research 2020. All Rights Reserved Worldwide Japan Trauma Data Bank Report 2020 Figure 19 Deaths by age and gender (ISS>15)

300

250

200 Female N=2430 Male N=5170 150

Number Number of Deaths 100

0 0 1–4 5–9 10–14 15–19 20–24 25–34 35–44 45–54 55–64 65–74 75–84 85–

■Female ■Male Age (Years) Deaths for patients with ISS>15 for males and females at each age category. © Japan Trauma Care and Research 2020. All Rights Reserved Worldwide Japan Trauma Data Bank Report 2020

Figure 20A Total hospital LOS and Injury Severity Score (ISS) N=19715 250,000 9506

200,000

150,000

3476 100,000 2099

4242 Total Hospital LOS Days in LOS Hospital Total 50,000 392

0 1–8 9–15 16–24 25–40 41–75 ISS Range Excluded: LOS<0 or >365 Proportional distribution of total hospital length of stay for patients, grouped by ISS range.

Figure 20B Average hospital LOS and Injury Severity Score N=19715

35 63162/2099 30 102989/9506 90919/3476 10436/392 25

20 51541 days 15/4242 patients

10 Average Hospital LOS Days in LOS Hospital Average

0 1–8 9–15 16–24 25–40 41–75 ISS Range Average hospital length of stay for each category of ISS range. (Average hospital length of stay = total hospital length of stay for each ISS range divided by the total number of patients).

Figure 21 Distribution of patients by probability of survival (Ps)

503, 2% 371, 2% 4,157, 19% 516, 2%

0-0.25 0.25-0.5 0.5-0.75 0.75-1.0 Unknown

16,542, 75%

Figure 22A Distribution of deaths by probability of survival (Ps)

267, 14% 0-0.1 0.1-0.2 613, 32% 122, 7% 0.2-0.3 57, 3% 0.3-0.4 0.4-0.5 0.5-0.6 158, 8% 0.6-0.7 0.7-0.8 49, 3% 0.8-0.9 80, 4% 0.9-1.0 286, 15% 61, 3% n/a 98, 5% 104, 6%

Figure 22B Case fatality by probability of survival (Ps)

100% 90% 80% 70% 60% 50%

Fatality 40% 30% 20% 10% 0%

Probability of survival

Figure 23 The number of patients in traffic accidents by types of vehicle and age

Car Motorcycle Bicycle Pedestrian Other vehicles

250

200

150

100

50 Number Number patients of

Age(years)

Figure 24 The number of patients in car accident by driver and passengers and age

driver Front-seat passenger Back-seat passenger 180

160

140

120

100

Number of patients of Number 60

Age(years)

Figure 25 The number of patients in car accident （driveｒ） by gender and age

120 Male Female

100

40 Number of patients

Figure 26 The number of patients in car accident （passengeｒ） by gender and age

Male Female

Number of patients of Number 5

Age(years)

Figure 27 Number of deaths and fatalities of motor vehicular drivers by age

25 25

20 20

15 15 Fatality(%)

10 10 Number of Deaths of Number

5 5

0 0 16～ 21～ 26～ 31～ 36～ 41～ 46～ 51～ 56～ 61～ 66～ 71～ 76～ 81～ 86～ 20 25 30 35 40 45 50 55 60 65 70 75 80 85 Number of Deaths 1 10 2 4 1 4 3 7 9 12 11 20 8 15 8 Fatality(%) 3.5 5.4 5.2 6.6 5.9 5.7 5.6 5.8 6.1 7.3 8.8 8.2 10.6 14.9 19.3

Figure Number of deaths of motor vehicular drivers by age and genders 28

10 Number of Patients of Number

0 16～ 21～ 26～ 31～ 36～ 41～ 46～ 51～ 56～ 61～ 66～ 71～ 76～ 81～ 86～ 20 25 30 35 40 45 50 55 60 65 70 75 80 85 Number of Female Deaths 0 3 0 0 0 1 1 1 3 3 2 5 1 2 1 Number of Male Deaths 1 7 2 4 1 3 2 6 6 9 9 15 7 13 7

Figure 29 Proportional distribution of registered patients, groped by intent

6, 0.0% 71, 0.3% 365, 1.7% 332, 1.5% Unintentional 1043, 4.8% Self-inflicted

Assault

Other (Law intervention)

Other (War or Riot)

Undetermined 19695, 89.2%

Figure 30 Proportional distribution of deaths, grouped by intent

0, 0.0% 116, 6.1% 5, 0.3% Unintentional 30, 1.6%

277, 14.6% Self-inflicted

Assault

Other (Law intervention)

Other (War or Riot)

Undetermined 1424, 75.1%

Figure 31 Gender proportion of unintentional

人patients 0.70% 146 0.70 % Male男性 Female女性 Unknown不明

7962人patients 40.4 %

11587人patients 58.8 %

Figure 32 Unintentional by age and gender

2800

2400

2000

Patients 1600 of 1200

800 Number

400

男性Male Female女性 Age (years)

Table 32 Unintentional by age and gender

Age Male Female total < 1 41 31 72 1‐ 4 117 83 200 5‐ 9 237 117 354 10‐14 182 77 259 15‐19 498 149 647 20‐24 498 143 641 25‐34 731 148 879 35‐44 887 196 1083 45‐54 1402 389 1791 55‐64 1446 540 1986 65‐74 2175 1210 3385 75‐84 2142 2211 4353 85‐ 1222 2661 3883 unknown 9 7 16 total 11587 7692 19549

Figure 33 Assault by age and gender

Patients of

20 Number 10

男性Male 女性Female Age (years)

Table 33 Assault by age and gender

Age Male Female total < 1 2 2 4 1‐ 4 1 3 4 5‐ 9 3 4 7 10‐14 5 3 8 15‐19 11 2 13 20‐24 18 3 21 25‐34 29 11 40 35‐44 33 9 42 45‐54 43 14 57 55‐64 30 11 41 65‐74 26 10 36 75‐84 17 22 39 85‐ 10 9 19 total 228 103 331

Figure 34 Self-inflicted by age and gender

100 90 80 70 60 50 40 30 20

Number of Patients of Number 10 0

Age (years) Male Female

Table 34 Self-inflicted by age and gender

AgeAge 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75- 80- 85- 90- Unkno 0-4 5-9 95- Total SexSex 14 19 24 29 34 39 44 49 54 59 64 69 74 79 84 89 94 wn

Female 40 72 6415 20546 36263 36343 34132 35125 36836 35849 24536 21422 21417 19225 16625 14527 919 549 138 92 6 3772491

Male 112 50 6520 18931 29331 33442 30848 40336 43242 37858 34847 24141 24640 27223 21922 16529 12619 617 296 191 141 4158546

Total 1537 1229 129168 394505 655770 697808 649684 754806 800841 736825 593707 455591 460530 464592 385512 310396 217319 115176 4269 2817 2042 79301037

Figure 35A Total hospital LOS by intent

450000 421135 400000 350000 300000 250000 200000 150000

Total Hospital LOS Days in LOS Hospital Total 100000 50000 24427 6267 1753 158 7295 0 Unintentional Self-inflicted Assault Undermined Other Unknown

Industrial accident was included in the category of “Unintentional”.

Figure 35B Average hospital LOS by intent

30.0 27.0 26.3 25.2 25.0 22.0 21.5 20.0 20.0

15.0

10.0

Average Hospital LOS in Days in LOS Hospital Average 5.0

0.0 Unintentional Self-inflicted Assault Undermined Other Unknown

Average hospital length of stay in days = total hospital length of stay divided by the number of patients by intent.

Figure 36 Number of patients with injured body parts based on AIS

10000 9419 9000 8000 6990 7000 6000 5265 5000 4329 4465 4000 3000 2576 1814 2000 1490 1000 294

Numberofpatients 0

Injured body part

Figure 37A Head injury and max AIS score

32, 0% 1020, 15% 1087, 16%

maxAIS 1 maxAIS 2 1220, 17% maxAIS 3 1369, 20% maxAIS 4 maxAIS 5 maxAIS 6

2262, 32%

Figure 37B Facial injury and max AIS score

76, 3% 11, 0%

875, 34% maxAIS 1 maxAIS 2 maxAIS 3 maxAIS 4

1614, 63%

Figure 37C Neck injury and max AIS score

18, 6% 2, 1%

66, 22% maxAIS 1 132, 45% maxAIS 2 maxAIS 3 maxAIS 4 maxAIS 5

76, 26%

Figure 37D Thoracic injury and max AIS score

43, 1% 200, 4% 447, 8% 591, 11%

845, 16% maxAIS 1 maxAIS 2 maxAIS 3 maxAIS 4 maxAIS 5 maxAIS 6

3139, 60%

Figure 37E Injury of abdomen/pelvic contents and max AIS score

44, 3% 2, 0% 260, 14% 241, 13%

maxAIS 1 maxAIS 2 maxAIS 3 maxAIS 4 maxAIS 5 maxAIS 6 605, 33% 662, 37%

Figure 37F Spinal injury and max AIS score

47, 1% 96, 2% 244, 6%

810, 19% maxAIS 1 maxAIS 2 maxAIS 3 maxAIS 4 maxAIS 5 2011, 46% maxAIS 6

1121, 26%

Figure 37G Injury of upper extremities and max AIS score

18, 1% 1, 0% 232, 5% 1165, 26%

maxAIS 1 maxAIS 2 maxAIS 3 maxAIS 4 maxAIS 5

3049, 68%

Figure 37H Injury of lower extremities and max AIS score

176, 2% 478, 5% 977, 10%

1957, 21% maxAIS 1 maxAIS 2 maxAIS 3 maxAIS 4 maxAIS 5

5831, 62%

Figure 37I Skin/burns/other trauma and max AIS score

14, 1% 225, 15% 898, 60%

maxAIS 1 90, 6% maxAIS 2 maxAIS 3

165, 11% maxAIS 4 maxAIS 5 maxAIS 6

98, 7%

Figure 38 Number of patients and injured body parts based on AIS

14000 12362 12000

10000

8000

6000 4426 4000 Numberofpatients 2370 2000 1212 484 142 26 2 0 1 2 3 4 5 6 7 8 Number of injured body parts

© Japan Trauma Care and Research 2020. All Rights Reserved Worldwide January, 2021 JAPAN TRAUMA DATA BANK REPORT 2020 (2019.1-2019.12) The Japanese Association for Acute Medicine Trustee: Tetsuya Sakamoto, MD Chairman: Naoto Morimura, MD The Japanese Association for the Surgery of Trauma Trustee: Daizoh Saitoh, MD Chairman:Yasuｆumi Miyake, MD Task Force: Tomokazu Abe, MD Jun Oda, MD Akio Kimura, MD Yuichiro Sakamoto, MD Atsushi Shiraishi, MD Keiji Tanaka, MD Hideo Tohira, MD Shinji Nakahara, MD Munetaka Hayashi, MD Tomohiko Masuno, MD Yasuｆumi Miyake, MD Yoshihiro Yamaguchi, MD Keiki Shimizu, MD Makoto Aoki, MD © Japan Trauma Care and Research 2020. All Rights Reserved Worldwide