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A statewide system of trauma care in Victoria: effect on patient survival
Author(s) -
Cameron Peter A,
Gabbe Belinda J,
Cooper D James,
Walker Tony,
Judson Rodney,
McNeil John
Publication year - 2008
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2008.tb02176.x
Subject(s) - medicine , major trauma , emergency medicine , injury severity score , odds ratio , population , injury prevention , poison control , cohort , trauma care , pediatrics , surgery , environmental health
Objective: To determine whether the statewide system of trauma care introduced in 2000 has resulted in improved survival for all major trauma patients in Victoria. Design, setting and participants: Population‐based cohort study using data from the Victorian State Trauma Registry (VSTR), a registry of all hospitalised major trauma patients in Victoria. The study included major trauma patients with an Injury Severity Score > 15 captured by the VSTR between July 2001 and June 2006. Main outcome measure: In‐hospital mortality. Results: The number of major trauma cases captured by the registry rose from 1153 in 2001–02 to 1737 in 2005–06. Adjusting for key predictors of mortality, there was a significant overall reduction between 2001–02 and 2005–06 in the risk of death for patients treated in the trauma system (adjusted odds ratio [AOR], 0.62 [95% CI, 0.48–0.80]). The reduced risk of death was also significant when road trauma cases (AOR, 0.56 [95% CI, 0.39–0.80]) and serious head injury cases (AOR, 0.62 [95% CI, 0.46–0.83]) were analysed separately. The proportion of road trauma patients definitively treated at one of the three major trauma service (MTS) hospitals in Victoria rose by 7% over the 5‐year period. Direct transfers from the scene of injury to MTS hospitals rose by 8% for all cases and 13% for road trauma cases over the same period. Conclusions: Introduction of a statewide trauma system was associated with a significant reduction in risk‐adjusted mortality. Such inclusive systems of trauma care should be regarded as a minimum standard for health jurisdictions.