Over view of major traumatic injury in Australia--Implications for trauma system design.

Adult Aged Aged, 80 and over Australia / epidemiology Female Humans Incidence Injury Severity Score Length of Stay / statistics & numerical data Male Middle Aged Registries Retrospective Studies Trauma Centers / statistics & numerical data Wounds and Injuries / diagnosis
Epidemiology Injury burden Major trauma Older adults Quality improvement Risk adjustment System of care Trauma registries Trauma system

Journal

Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 08 08 2019
revised: 06 09 2019
accepted: 30 09 2019
pubmed: 15 10 2019
medline: 27 11 2020
entrez: 15 10 2019
Statut: ppublish

Résumé

Trauma registries are known to drive improvements and optimise trauma systems worldwide. This is the first reported comparison of the epidemiology and outcomes at major centres across Australia. The Australian Trauma Registry was a collaboration of 26 major trauma centres across Australia at the time of this study and currently collects information on patients admitted to these centres who die after injury and/or sustain major trauma (Injury Severity Score (ISS) > 12). Data from 1 July 2016 to 30 June 2017 were analysed. Primary endpoints were risk adjusted length of stay and mortality (adjusted for age, cause of injury, arrival Glasgow coma scale (GCS), shock-index grouped in quartiles and ISS). There were 8423 patients from 24 centres included. The median age (IQR) was 48 (28-68) years. Median (IQR) ISS was 17 (14-25). There was a predominance of males (72%) apart from the extremes of age. Transport-related cases accounted for 45% of major trauma, followed by falls (35.1%). Patients took 1.42 (1.03-2.12) h to reach hospital and spent 7.10 (3.64-15.00) days in hospital. Risk adjusted length of stay and mortality did not differ significantly across sites. Primary endpoints across sites were also similar in paediatric and older adult (>65) age groups. Australia has the capability to identify national injury trends to target prevention and reduce the burden of injury. Quality of care following injury can now be benchmarked across Australia and with the planned enhancements to data collection and reporting, this will enable improved management of trauma victims.

Sections du résumé

BACKGROUND BACKGROUND
Trauma registries are known to drive improvements and optimise trauma systems worldwide. This is the first reported comparison of the epidemiology and outcomes at major centres across Australia.
METHODS METHODS
The Australian Trauma Registry was a collaboration of 26 major trauma centres across Australia at the time of this study and currently collects information on patients admitted to these centres who die after injury and/or sustain major trauma (Injury Severity Score (ISS) > 12). Data from 1 July 2016 to 30 June 2017 were analysed. Primary endpoints were risk adjusted length of stay and mortality (adjusted for age, cause of injury, arrival Glasgow coma scale (GCS), shock-index grouped in quartiles and ISS).
RESULTS RESULTS
There were 8423 patients from 24 centres included. The median age (IQR) was 48 (28-68) years. Median (IQR) ISS was 17 (14-25). There was a predominance of males (72%) apart from the extremes of age. Transport-related cases accounted for 45% of major trauma, followed by falls (35.1%). Patients took 1.42 (1.03-2.12) h to reach hospital and spent 7.10 (3.64-15.00) days in hospital. Risk adjusted length of stay and mortality did not differ significantly across sites. Primary endpoints across sites were also similar in paediatric and older adult (>65) age groups.
CONCLUSION CONCLUSIONS
Australia has the capability to identify national injury trends to target prevention and reduce the burden of injury. Quality of care following injury can now be benchmarked across Australia and with the planned enhancements to data collection and reporting, this will enable improved management of trauma victims.

Identifiants

DOI: 10.1016/j.injury.2019.09.036 PMID: 31607442
pubmed: 31607442
pii: S0020-1383(19)30561-3
doi: 10.1016/j.injury.2019.09.036
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

114-121

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

P A Cameron (PA)

Emergency & Trauma Centre, The Alfred, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: peter.cameron@monash.edu.

M C Fitzgerald (MC)

National Trauma Research Institute, The Alfred, Melbourne, Victoria, Australia; Central Clinical School, Monash University, Melbourne, Australia; Trauma Service, The Alfred, Melbourne, Victoria, Australia.

K Curtis (K)

Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia; George Institute for Global Health, Sydney, Australia; Illawarra Shoalhaven Local Health District, New South Wales, Australia.

E McKie (E)

School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

B Gabbe (B)

School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Health Data Research UK, Swansea University Medical School, Swansea University, UK.

A Earnest (A)

School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

G Christey (G)

Midland Trauma System, New Zealand; Waikato Clinical School, University of Auckland, New Zealand.

C Clarke (C)

Royal Adelaide Hospital, Australia; University of Adelaide, Australia.

J Crozier (J)

Royal Australasian College of Surgeons, Australia; Liverpool Hospital, Sydney, NSW, Australia.

M Dinh (M)

Emergency, Royal Prince Alfred Hospital, Australia; NSW Institute of Trauma and Injury Management, Agency for Clinical Innovation, Australia; Sydney Medical School, The University of Sydney, Australia.

D Y Ellis (DY)

Trauma Centre, Royal Adelaide Hospital, South Australia, Australia; SAAS MedSTAR, Emergency Medical Retrieval Service, Australia; School of Public Health and Tropical Medicine, James Cook University.

T Howard (T)

National Trauma Research Institute, The Alfred, Melbourne, Victoria, Australia; Central Clinical School, Monash University.

A P Joseph (AP)

Sydney Medical School, The University of Sydney, Australia; Emergency Department and Trauma Service, Royal North Shore Hospital, Sydney NSW.

K McDermott (K)

National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia.

J Matthew (J)

Emergency & Trauma Centre, The Alfred, Melbourne, Victoria, Australia; National Trauma Research Institute, The Alfred, Melbourne, Victoria, Australia; Central Clinical School, Monash University, Melbourne, Australia; Trauma Service, The Alfred, Melbourne, Victoria, Australia.

R Ogilvie (R)

School of Nursing Midwifery & Public Health, University of Canberra, Australian Capital Territory, Australia; ACT Trauma Service, Canberra Hospital & Health Services, Australian Capital Territory, Australia.

C Pollard (C)

Jamieson Trauma Institute, RBWH, Australia.

S Rao (S)

Royal Perth Hospital, Western Australia, Australia.

M Reade (M)

Faculty of Medicine, University of Queensland, Brisbane, Australia and Joint Health Command, Australian Defence Force, Canberra, Australia.

N Rushworth (N)

Brain Injury Australia, Australia.

S Zalstein (S)

Trauma Centre, Royal Hobart Hospital, Hobart, Tasmania, Australia.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Over view of major traumatic injury in...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Over view of major traumatic injury in...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sujet âgé de 80 ans ou plus › Over view of major traumatic injury in...
questionsmedicales.fr › Régions géographiques › Océanie › Australasie › Australie › Over view of major traumatic injury in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Over view of major traumatic injury in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Incidence › Over view of major traumatic injury in...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Score de gravité des lésions traumatiques › Over view of major traumatic injury in...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Durée du séjour › Over view of major traumatic injury in...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Over view of major traumatic injury in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enregistrements › Over view of major traumatic injury in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Over view of major traumatic injury in...
questionsmedicales.fr › Administration des services de santé › Organisation et administration › Administration d'établissement de santé › Administration hospitalière › Services hospitaliers › Service hospitalier d'urgences › Centres de traumatologie › Over view of major traumatic injury in...
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