Document Detail


Outcome of patients with neurotrauma: the effect of a regionalized trauma system.
MedLine Citation:
PMID:  7857235     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A system of regionalized trauma care was introduced to Sydney in early 1992. This study was carried out to assess the effect of regionalization on the outcome of patients suffering major head injury within the central Sydney area. A prospective before and after study extending over 3 years and centred on the time of designation of Royal Prince Alfred Hospital (RPAH) as a trauma centre, was the methodology used. The study group consisted of all patients admitted with head injury (Glasgow Coma Score < 9; admission systolic blood pressure > 90 mmHg; Injury Severity Score > 15) to RPAH from the central Sydney area. Outcome criteria include survival rates, transfer numbers, and time to definitive neurosurgical care. Fifty patients were entered during the first 18 months of the study, and 38 during the second 18 months. Fifteen in the first group required evacuation of intracranial mass lesions, as did nine in the second group. The overall mortality fell from 42 to 26% (P = 0.13). During the study period there were 77 primary retrievals and 20 required evacuation of mass lesions. The median time from injury to commencement of operation in these patients was 2 h 13 min (range 1 h 3 min-5 h 35 min). There were 11 transfers, four requiring craniotomy. The median time from injury to surgery was 7 h 24 min (range 3 h 2 min-10 h 25 min; P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J Hunt; D Hill; M Besser; R West; S Roncal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Australian and New Zealand journal of surgery     Volume:  65     ISSN:  0004-8682     ISO Abbreviation:  Aust N Z J Surg     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-03-14     Completed Date:  1995-03-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0373115     Medline TA:  Aust N Z J Surg     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  83-6     Citation Subset:  IM    
Affiliation:
Division of Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Brain Injuries / mortality*,  surgery
Cerebral Hemorrhage / surgery
Female
Glasgow Coma Scale
Hematoma / surgery
Hematoma, Subdural / surgery
Humans
Male
Middle Aged
New South Wales / epidemiology
Outcome Assessment (Health Care)*
Regional Medical Programs / organization & administration*
Transportation of Patients
Trauma Centers / organization & administration*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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