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A comparison of major trauma patients transported to trauma centres vs. non-trauma centres in metropolitan Perth.
MedLine Citation:
PMID:  21334800     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Some major trauma patients in metropolitan Perth (area 5000km(2)) are initially transported to a secondary hospital (non-trauma centre), rather than directly to a tertiary hospital (trauma centre). They are subsequently transferred to a tertiary hospital. We compared outcomes from these different systems of care. METHODS: Major trauma (Injury Severity Score, ISS>15) data from the Trauma Registries, 1 July 1997-30 June 2006. Two groups were studied: group 1 (metropolitan major trauma transported directly to a tertiary hospital) and group 2 (metropolitan major trauma transported initially to a secondary hospital and then to a tertiary hospital). The primary endpoint was death. RESULTS: Group 1 (n=2005) and group 2 (n=1078) mean age (43.9±24.3 yrs vs. 39.1±24.3 yrs, p<0.0001) both with a median ISS=24 (p=0.084). Group 2 had significantly more head/neck injuries (p<0.0001) and significantly less thoracic, abdominal and pelvis/extremities injuries (p<0.0001). There were also a significantly greater total number of regions injured in group 1 vs. group 2 (p<0.0001). Mean times to definitive care were 59min vs. 4.5h, respectively (p<0.0001). After adjusting for age, ISS, RTS, total regions injured and time, the OR for death in group 2 was 0.99 (95% CI 0.58-1.68). CONCLUSION: There is an equivalent risk of major trauma death in these two systems of care. In our metropolitan area, we were unable to demonstrate a mortality benefit associated with time.
Authors:
Daniel M Fatovich; Michael Phillips; Ian G Jacobs
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-18
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Emergency Medicine, Royal Perth Hospital, University of Western Australia, Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research, Australia.
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