Trauma care systems: a comparison of trauma care in Victoria, Australia, and Hong Kong, China.
BACKGROUND
Despite the high incidence of major trauma, few studies have directly compared the performance of trauma systems. This study compared the trauma system performance in Victoria, Australia, (VIC) and Hong Kong, China (HK).


METHODS
Prospectively collected data over 5 years from January 2001 from the 2 trauma systems were compared using univariate analysis. Variables were then entered into a multivariate logistic regression to assess differences in outcome between the systems and adjusted for effects of clinically important factors.


RESULTS
Five thousand five thirty-six cases from VIC and 580 cases from HK were taken for analysis. The HK group was older, but mechanisms of injury were similar in both systems. Thoracic and abdominal trauma was more common in VIC, compared with more head injuries in HK. More patients were admitted to intensive care in VIC and patients stayed in intensive care 1 day longer on average, despite more comorbidity in HK patients. Overall mortality was 20.2% for HK and 11.9% for VIC (X(2)(1) = 32.223, P < 0.001).


CONCLUSIONS
The performance of the HK trauma system was comparable to international standards, but there was a significant difference in the probability of survival of major trauma between the 2 systems. Possible modifiable factors may include criteria for activation of trauma calls and improved ICU utilization.
Cheng
C H
CH
Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Trauma and Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China. cx1662@gmail.com
Graham
Colin A
CA
Gabbe
Belinda J
BJ
Yeung
Janice H H
JH
Kossmann
Thomas
T
Judson
Rodney T
RT
Rainer
Timothy H
TH
Cameron
Peter A
PA
D000328:Adult; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008485:Medical Audit / Q000379:methods*; D008875:Middle Aged; D011787:Quality of Health Care / Q000592:standards*; D012042:Registries; D014193:Trauma Centers / Q000592:standards* / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D014739:Victoria / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology / Q000628:therapy*