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.
OBJECTIVE: To determine whether the statewide system of trauma care introduced in 2000 has resulted in improved survival for all major traumapatients 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 traumapatients in Victoria. The study included major traumapatients 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 traumapatients 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.
Authors: Alvaro I Sánchez; Robert T Krafty; Harold B Weiss; Andrés M Rubiano; Andrew B Peitzman; Juan Carlos Puyana Journal: J Head Trauma Rehabil Date: 2012 Mar-Apr Impact factor: 2.710
Authors: Lynne Moore; Howard Champion; Pier-Alexandre Tardif; Brice-Lionel Kuimi; Gerard O'Reilly; Ari Leppaniemi; Peter Cameron; Cameron S Palmer; Fikri M Abu-Zidan; Belinda Gabbe; Christine Gaarder; Natalie Yanchar; Henry Thomas Stelfox; Raul Coimbra; John Kortbeek; Vanessa K Noonan; Amy Gunning; Malcolm Gordon; Monty Khajanchi; Teegwendé V Porgo; Alexis F Turgeon; Luke Leenen Journal: World J Surg Date: 2018-05 Impact factor: 3.352