Injury trends and mortality in adult patients with major trauma in New South Wales.
OBJECTIVE
To examine trends in mechanism and outcome of major traumatic injury in adults since the implementation of the New South Wales trauma monitoring program, and to identify factors associated with mortality.


METHODS
Retrospective review of NSW Trauma Registry data from 1 January 2003 to 31 December 2007, including patient demographics, year of injury, and level of trauma centre where definitive treatment was provided.


METHODS
9769 people aged ≥ 15 years hospitalised for trauma, with an injury severity score (ISS) > 15.


METHODS
The NSW Trauma Registry outcome measures included were overall hospital length of stay, length of stay in an intensive care unit and in ospital mortality.


RESULTS
There was a decreasing trend in severe trauma presentations in the age group 16-34 years, and an increasing trend in presentations of older people, particularly those aged ≥ 75 years. Road trauma and falls were consistently the commonest injury mechanisms. There were 1328 inhospital deaths (13.6%). Year of injury, level of trauma centre, ISS, head/neck injury and age were all independent predictors of mortality. The odds of mortality was significantly higher among patients receiving definitive care at regional trauma centres compared with Level I centres (odds ratio, 1.34; 95% CI, 1.10-1.63).


CONCLUSIONS
Deaths from major trauma in NSW trauma centres have declined since 2003, and definitive care at a Level 1 trauma centre was associated with a survival benefit. More comprehensive trauma data collection with timely analysis will improve injury surveillance and better inform health policy in NSW.
Sydney Nursing School, University of Sydney, Sydney, NSW, Australia. kate.curtis@sydney.edu.au
Kate A
KA
Curtis
Rebecca J
RJ
Mitchell
Shanley S
SS
Chong
Zsolt J
ZJ
Balogh
Duncan J
DJ
Reed
Peter T
PT
Clark
Scott
S
D'Amours
Deborah A
DA
Black
Mary E
ME
Langcake
Colman B
CB
Taylor
Patricia
P
McDougall
Peter A
PA
Cameron
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009517:New South Wales / Q000453:epidemiology; D016017:Odds Ratio; D010360:Patient Transfer / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014193:Trauma Centers / Q000592:standards / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D055815:Young Adult