Overview of Major Traumatic Injury in Australia - Implications for Trauma System Design

Peter Cameron, Mark Fitzgerald, Kate Curtis, Emily McKie, Belinda Gabbe, Arul Earnest, Grant Christey, Chris Clarke, John Crozier, Michael Dinh, Daniel Ellis, Theresa Howard, Anthony Joseph, Kathleen McDermott, Joseph Matthew, Rebekah Ogilvie, Cliff Pollard, Sudhakar Rao, Michael Reade, Nick Rushworth & 1 others Sandy Zalstein

Research output: Contribution to journalArticle

Abstract

Background: Trauma registries are known to drive improvements and optimise trauma systems worldwide. This is the first reported comparison of the epidemiology and outcomes at major centres across Australia. Methods: The Australian Trauma Registry was a collaboration of 26 major trauma centres across Australia at the time of this study and currently collects information on patients admitted to these centres who die after injury and/or sustain major trauma (Injury Severity Score (ISS) > 12). Data from 1 July 2016 to 30 June 2017 were analysed. Primary endpoints were risk adjusted length of stay and mortality (adjusted for age, cause of injury, arrival Glasgow coma scale (GCS), shock-index grouped in quartiles and ISS). Results: There were 8423 patients from 24 centres included. The median age (IQR) was 48 (28–68) years. Median (IQR) ISS was 17 (14–25). There was a predominance of males (72%) apart from the extremes of age. Transport-related cases accounted for 45% of major trauma, followed by falls (35.1%). Patients took 1.42 (1.03–2.12) h to reach hospital and spent 7.10 (3.64–15.00) days in hospital. Risk adjusted length of stay and mortality did not differ significantly across sites. Primary endpoints across sites were also similar in paediatric and older adult (>65) age groups. Conclusion: Australia has the capability to identify national injury trends to target prevention and reduce the burden of injury. Quality of care following injury can now be benchmarked across Australia and with the planned enhancements to data collection and reporting, this will enable improved management of trauma victims.
Original languageEnglish
JournalInjury
DOIs
Publication statusAccepted/In press - 3 Oct 2019

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Wounds and Injuries
Injury Severity Score
Registries
Length of Stay
Glasgow Coma Scale
Time and Motion Studies
Mortality
Quality of Health Care
Trauma Centers
Shock
Epidemiology
Research Design
Age Groups
Pediatrics

Cite this

Cameron, P., Fitzgerald, M., Curtis, K., McKie, E., Gabbe, B., Earnest, A., ... Zalstein, S. (Accepted/In press). Overview of Major Traumatic Injury in Australia - Implications for Trauma System Design. Injury. https://doi.org/10.1016/j.injury.2019.09.036
Cameron, Peter ; Fitzgerald, Mark ; Curtis, Kate ; McKie, Emily ; Gabbe, Belinda ; Earnest, Arul ; Christey, Grant ; Clarke, Chris ; Crozier, John ; Dinh, Michael ; Ellis, Daniel ; Howard, Theresa ; Joseph, Anthony ; McDermott, Kathleen ; Matthew, Joseph ; Ogilvie, Rebekah ; Pollard, Cliff ; Rao, Sudhakar ; Reade, Michael ; Rushworth, Nick ; Zalstein, Sandy. / Overview of Major Traumatic Injury in Australia - Implications for Trauma System Design. In: Injury. 2019.
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abstract = "Background: Trauma registries are known to drive improvements and optimise trauma systems worldwide. This is the first reported comparison of the epidemiology and outcomes at major centres across Australia. Methods: The Australian Trauma Registry was a collaboration of 26 major trauma centres across Australia at the time of this study and currently collects information on patients admitted to these centres who die after injury and/or sustain major trauma (Injury Severity Score (ISS) > 12). Data from 1 July 2016 to 30 June 2017 were analysed. Primary endpoints were risk adjusted length of stay and mortality (adjusted for age, cause of injury, arrival Glasgow coma scale (GCS), shock-index grouped in quartiles and ISS). Results: There were 8423 patients from 24 centres included. The median age (IQR) was 48 (28–68) years. Median (IQR) ISS was 17 (14–25). There was a predominance of males (72{\%}) apart from the extremes of age. Transport-related cases accounted for 45{\%} of major trauma, followed by falls (35.1{\%}). Patients took 1.42 (1.03–2.12) h to reach hospital and spent 7.10 (3.64–15.00) days in hospital. Risk adjusted length of stay and mortality did not differ significantly across sites. Primary endpoints across sites were also similar in paediatric and older adult (>65) age groups. Conclusion: Australia has the capability to identify national injury trends to target prevention and reduce the burden of injury. Quality of care following injury can now be benchmarked across Australia and with the planned enhancements to data collection and reporting, this will enable improved management of trauma victims.",
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author = "Peter Cameron and Mark Fitzgerald and Kate Curtis and Emily McKie and Belinda Gabbe and Arul Earnest and Grant Christey and Chris Clarke and John Crozier and Michael Dinh and Daniel Ellis and Theresa Howard and Anthony Joseph and Kathleen McDermott and Joseph Matthew and Rebekah Ogilvie and Cliff Pollard and Sudhakar Rao and Michael Reade and Nick Rushworth and Sandy Zalstein",
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Cameron, P, Fitzgerald, M, Curtis, K, McKie, E, Gabbe, B, Earnest, A, Christey, G, Clarke, C, Crozier, J, Dinh, M, Ellis, D, Howard, T, Joseph, A, McDermott, K, Matthew, J, Ogilvie, R, Pollard, C, Rao, S, Reade, M, Rushworth, N & Zalstein, S 2019, 'Overview of Major Traumatic Injury in Australia - Implications for Trauma System Design', Injury. https://doi.org/10.1016/j.injury.2019.09.036

Overview of Major Traumatic Injury in Australia - Implications for Trauma System Design. / Cameron, Peter; Fitzgerald, Mark; Curtis, Kate; McKie, Emily; Gabbe, Belinda; Earnest, Arul; Christey, Grant; Clarke, Chris; Crozier, John; Dinh, Michael; Ellis, Daniel; Howard, Theresa; Joseph, Anthony; McDermott, Kathleen; Matthew, Joseph; Ogilvie, Rebekah; Pollard, Cliff; Rao, Sudhakar; Reade, Michael; Rushworth, Nick; Zalstein, Sandy.

In: Injury, 03.10.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Overview of Major Traumatic Injury in Australia - Implications for Trauma System Design

AU - Cameron, Peter

AU - Fitzgerald, Mark

AU - Curtis, Kate

AU - McKie, Emily

AU - Gabbe, Belinda

AU - Earnest, Arul

AU - Christey, Grant

AU - Clarke, Chris

AU - Crozier, John

AU - Dinh, Michael

AU - Ellis, Daniel

AU - Howard, Theresa

AU - Joseph, Anthony

AU - McDermott, Kathleen

AU - Matthew, Joseph

AU - Ogilvie, Rebekah

AU - Pollard, Cliff

AU - Rao, Sudhakar

AU - Reade, Michael

AU - Rushworth, Nick

AU - Zalstein, Sandy

PY - 2019/10/3

Y1 - 2019/10/3

N2 - Background: Trauma registries are known to drive improvements and optimise trauma systems worldwide. This is the first reported comparison of the epidemiology and outcomes at major centres across Australia. Methods: The Australian Trauma Registry was a collaboration of 26 major trauma centres across Australia at the time of this study and currently collects information on patients admitted to these centres who die after injury and/or sustain major trauma (Injury Severity Score (ISS) > 12). Data from 1 July 2016 to 30 June 2017 were analysed. Primary endpoints were risk adjusted length of stay and mortality (adjusted for age, cause of injury, arrival Glasgow coma scale (GCS), shock-index grouped in quartiles and ISS). Results: There were 8423 patients from 24 centres included. The median age (IQR) was 48 (28–68) years. Median (IQR) ISS was 17 (14–25). There was a predominance of males (72%) apart from the extremes of age. Transport-related cases accounted for 45% of major trauma, followed by falls (35.1%). Patients took 1.42 (1.03–2.12) h to reach hospital and spent 7.10 (3.64–15.00) days in hospital. Risk adjusted length of stay and mortality did not differ significantly across sites. Primary endpoints across sites were also similar in paediatric and older adult (>65) age groups. Conclusion: Australia has the capability to identify national injury trends to target prevention and reduce the burden of injury. Quality of care following injury can now be benchmarked across Australia and with the planned enhancements to data collection and reporting, this will enable improved management of trauma victims.

AB - Background: Trauma registries are known to drive improvements and optimise trauma systems worldwide. This is the first reported comparison of the epidemiology and outcomes at major centres across Australia. Methods: The Australian Trauma Registry was a collaboration of 26 major trauma centres across Australia at the time of this study and currently collects information on patients admitted to these centres who die after injury and/or sustain major trauma (Injury Severity Score (ISS) > 12). Data from 1 July 2016 to 30 June 2017 were analysed. Primary endpoints were risk adjusted length of stay and mortality (adjusted for age, cause of injury, arrival Glasgow coma scale (GCS), shock-index grouped in quartiles and ISS). Results: There were 8423 patients from 24 centres included. The median age (IQR) was 48 (28–68) years. Median (IQR) ISS was 17 (14–25). There was a predominance of males (72%) apart from the extremes of age. Transport-related cases accounted for 45% of major trauma, followed by falls (35.1%). Patients took 1.42 (1.03–2.12) h to reach hospital and spent 7.10 (3.64–15.00) days in hospital. Risk adjusted length of stay and mortality did not differ significantly across sites. Primary endpoints across sites were also similar in paediatric and older adult (>65) age groups. Conclusion: Australia has the capability to identify national injury trends to target prevention and reduce the burden of injury. Quality of care following injury can now be benchmarked across Australia and with the planned enhancements to data collection and reporting, this will enable improved management of trauma victims.

KW - Trauma systems

KW - Injury

KW - Major trauma

KW - Quality improvement

KW - Trauma system

KW - Injury burden

KW - System of care

KW - Risk adjustment

KW - Trauma registries

KW - Epidemiology

KW - Older adults

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U2 - 10.1016/j.injury.2019.09.036

DO - 10.1016/j.injury.2019.09.036

M3 - Article

JO - Injury

JF - Injury

SN - 1572-3461

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