A comparison of severely injured trauma patients admitted to level 1 trauma centres in Queensland and Germany.
BACKGROUND
The allocation of a trauma network in Queensland is still in the developmental phase. In a search for indicators to improve trauma care both locally as state-wide, a study was carried out comparing trauma patients in Queensland to trauma patients in Germany, a country with 82.4 million inhabitants and a well-established trauma system.


METHODS
Trauma patients > or =15 years of age, with an Injury Severity Score (ISS) > or = 16 admitted to the Princess Alexandra Hospital (PAH) and to the 59 German hospitals participating in the Trauma Registry of the German Society for Trauma Surgery (DGU-G) during the year 2005 were retrospectively identified and analysed.


RESULTS
Both cohorts are comparable when it comes to demographics and injury mechanism, but differ significantly in other important aspects. Striking is the low number of primary admitted patients in the PAH cohort: 58% versus 83% in the DGU-G cohort. PAH patients were less physiologically deranged and less severely injured: ISS 25.2 +/- 9.9 versus 29.9 +/- 13.1 (P < 0.001). Subsequently, they less often needed surgery (61% versus 79%), ICU admission (49% versus 92%) and had a lower mortality: 9.8% versus 17.9% of the DGU-G cohort.


CONCLUSIONS
Relevant differences were the low number of primary admissions, the lesser severity of injuries, and the low mortality of the patients treated at the PAH. These differences are likely to be interrelated and Queensland's size and suboptimal organization of trauma care may have played an important role.
Nijboer
Johanna M M
JM
Department of Surgery - Trauma Service, Princess Alexandra Hospital, Brisbane, Australia.
Wullschleger
Martin E
ME
Nielsen
Susan E
SE
McNamee
Anitia M
AM
Lefering
Rolf
R
ten Duis
Hendrik-Jan
HJ
Schuetz
Michael A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011793:Queensland; D012042:Registries; D012189:Retrospective Studies; D014193:Trauma Centers / Q000458:organization & administration / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy*; D055815:Young Adult