Risk of death among cases attending South Australian major trauma services after severe trauma: the first 4 years of operation of a state trauma system.
BACKGROUND
Factors predictive of death at South Australian major trauma services were investigated among 8,654 patients who had experienced severe trauma from 1997 to 2000.


METHODS
Univariate and multivariate analyses of age, sex, injury severity, presence of comorbid conditions, and calendar year of presentation were performed.


RESULTS
Multiple logistic regression indicated that factors predictive of death were older age; higher injury severity as indicated by the New Injury Severity Score and the Revised Trauma Score; and accompanying chronic liver disease, ischemic heart disease, and chronic renal failure. A decrease in risk of death by calendar year was statistically significant (p = 0.001). Using 1997 as the reference, the relative odds of death were 0.86 (95% confidence limits) (0.53, 1.39) for 1998, 0.60 (0.36, 0.99) for 1999, and 0.45 (0.27, 0.76) for 2000.


CONCLUSIONS
Results show a decrease in risk of death of patients attending South Australian major trauma services, from injuries of equivalent severity, during the first 4 years of operation of the State Trauma System.
Brennan
Peter W
PW
Master of Applied Epidemiology (Disease Control) Program, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia.
Everest
Evan R
ER
Griggs
William M
WM
Slater
Anthony
A
Carter
Libby
L
Lee
Christine
C
Semmens
Julie K
JK
Wood
Debra J
DJ
Nguyen
Anh-Minh T
AM
Owen
Dorothy L
DL
Pilkington
Prudence
P
Roder
David M
DM
Somers
Ronald L
RL
D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009936:Organizational Innovation; D011787:Quality of Health Care; D012306:Risk; D013021:South Australia / Q000453:epidemiology; D018709:Statistics, Nonparametric; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000453:epidemiology / Q000401:mortality*