title: A statewide system of trauma care in Victoria: effect on patient survival.
abstract: OBJECTIVE
  To determine whether the statewide system of trauma care introduced in 2000 has resulted in improved survival for all major trauma patients in Victoria.
  
  
  METHODS
  Population-based cohort study using data from the Victorian State Trauma Registry (VSTR), a registry of all hospitalised major trauma patients in Victoria. The study included major trauma patients with an Injury Severity Score > 15 captured by the VSTR between July 2001 and June 2006.
  
  
  METHODS
  In-hospital mortality.
  
  
  RESULTS
  The number of major trauma cases captured by the registry rose from 1153 in 2001-02 to 1737 in 2005-06. Adjusting for key predictors of mortality, there was a significant overall reduction between 2001-02 and 2005-06 in the risk of death for patients treated in the trauma system (adjusted odds ratio [AOR], 0.62 [95% CI, 0.48-0.80]). The reduced risk of death was also significant when road trauma cases (AOR, 0.56 [95% CI, 0.39-0.80]) and serious head injury cases (AOR, 0.62 [95% CI, 0.46-0.83]) were analysed separately. The proportion of road trauma patients definitively treated at one of the three major trauma service (MTS) hospitals in Victoria rose by 7% over the 5-year period. Direct transfers from the scene of injury to MTS hospitals rose by 8% for all cases and 13% for road trauma cases over the same period.
  
  
  CONCLUSIONS
  Introduction of a statewide trauma system was associated with a significant reduction in risk-adjusted mortality. Such inclusive systems of trauma care should be regarded as a minimum standard for health jurisdictions.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Peter.Cameron@med.monash.edu.au
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
authors.forename: Belinda J
authors.initials: BJ
authors.lastname: Gabbe
authors.forename: D James
authors.initials: DJ
authors.lastname: Cooper
authors.forename: Tony
authors.initials: T
authors.lastname: Walker
authors.forename: Rodney
authors.initials: R
authors.lastname: Judson
authors.forename: John
authors.initials: J
authors.lastname: McNeil
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012041:Regional Medical Programs / Q000458:organization & administration*; D012042:Registries; D012189:Retrospective Studies; D014194:Traumatology / Q000458:organization & administration*; D014739:Victoria / Q000453:epidemiology; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy*; D055815:Young Adult