Trauma Centre division
22 August 2012
Patients who attend regional trauma centres have less chance of surviving than seriously injured people who attend a major metropolitan trauma centre, according to a study conducted at Sydney Nursing School.
The study's findings published in this month's Medical Journal of Australia were based on NSW Trauma Registry data from 2003 to 2007 for patients aged 15 and over. It showed that the proportion of patients receiving care at a regional trauma centre increased over time, even though mortality rates were significantly higher than at a major Level I trauma centre.
The study led by Associate Professor Kate Curtis, an internationally recognised trauma nurse and co-authored by Dr Peter Clark, Chief Executive, NSW Institute of Trauma and Injury Management, is the first state-wide analysis of major adult trauma trends in NSW.
"Regional trauma centres play an important role in the delivery of trauma care, but often lack specialty resources," the authors wrote.
The authors also noted that, in 2008, Ambulance NSW introduced 'Protocol T1', which specifies that patients with major trauma should be taken directly to a Level I centre, bypassing lower-level centres, if transport time is within one hour.
"The benefits of primary transport or early inter-hospital transfer of patients with major trauma to a Level I trauma centre are confirmed in our study," they wrote.
The authors found a small reduction in mortality after major trauma over the study period. However, they noted that trauma remained the leading cause of death in those under 45 years of age, and that enhanced trauma monitoring and peer review is required.
Major metropolitan centres received a higher proportion of fatally injured patients who were pedestrians, or had fallen more than a metre or had suffered burns or violence. Deaths at regional trauma centres more commonly resulted from motorcycle or bicycle crashes.
Road trauma and falls were the most common causes of injury and, over the study period, motor vehicle crashes decreased as a cause of injury while falls increased.
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