TY - JOUR AU - Seppelt I. AU - Ivers R. AU - Dinh M. AU - Curtis K. AU - Bein K. AU - S. Russell Berendsen AU - Rigby O. AU - Mitchell R. AU - Balogh Z. AU - Deans C. AB -

OBJECTIVE: To determine trends in crude and risk-adjusted mortality for major trauma patients injured in rural or metropolitan New South Wales, 2009-2014. DESIGN: A retrospective analysis of NSW statewide trauma registry data. PARTICIPANTS: Adult patients (aged 16 years or more) who presented with major trauma (Injury Severity Scores greater than 15) to a NSW hospital during 2009-2014. MAIN OUTCOME MEASURES: The main covariate of interest was geographic location of injury (metropolitan v rural/regional areas). Inpatient mortality was analysed by multivariable logistic regression. RESULTS: Data for 11 423 eligible patients were analysed. Inpatient mortality for those injured in metropolitan locations was 14.7% in 2009 and 16.1% in 2014 (P = 0.45). In rural locations, there was a statistically significant decline in in-hospital mortality over the study period, from 12.1% in 2009 to 8.7% in 2014 (P = 0.004). Risk-adjusted mortality for those injured in a rural location was lower in 2013 than during 2009, but remained stable for those injured in metropolitan locations. CONCLUSION: Crude and risk-adjusted mortality after major trauma have remained stable in those injured in metropolitan areas of NSW between 2009 and 2014. The apparent downward trend in mortality associated with severe trauma in rural/regional locations requires further analysis.

AD - Sydney Medical School, University of Sydney, Sydney, NSW dinh.mm@gmail.com.
Sydney Nursing School, University of Sydney, Sydney, NSW.
Australian Institute of Health Innovation, Macquarie University, Sydney, NSW.
Royal Prince Alfred Hospital, Sydney, NSW.
John Hunter Hospital, Newcastle, NSW.
Nepean Hospital, Penrith, NSW.
Ambulance Service of New South Wales, Sydney, NSW.
The George Institute for Global Health, Sydney, NSW.
Institute of Trauma and Injury Management, New South Wales Agency for Clinical Innovation, Sydney, NSW. AN - 27809736 BT - Medical Journal of Australia CN - [IF]: 4.089 DP - NLM ET - 2016/11/05 J2 - The Medical journal of Australia LA - Eng LB - AUS
CCT
INJ
FY17 M1 - 9 N1 - Dinh, Michael M
Curtis, Kate
Mitchell, Rebecca J
Bein, Kendall J
Balogh, Zsolt J
Seppelt, Ian
Deans, Colin
Ivers, Rebecca
Berendsen Russell, Saartje
Rigby, Oran
Australia
Med J Aust. 2016 Nov 7;205(9):403-407. N2 -

OBJECTIVE: To determine trends in crude and risk-adjusted mortality for major trauma patients injured in rural or metropolitan New South Wales, 2009-2014. DESIGN: A retrospective analysis of NSW statewide trauma registry data. PARTICIPANTS: Adult patients (aged 16 years or more) who presented with major trauma (Injury Severity Scores greater than 15) to a NSW hospital during 2009-2014. MAIN OUTCOME MEASURES: The main covariate of interest was geographic location of injury (metropolitan v rural/regional areas). Inpatient mortality was analysed by multivariable logistic regression. RESULTS: Data for 11 423 eligible patients were analysed. Inpatient mortality for those injured in metropolitan locations was 14.7% in 2009 and 16.1% in 2014 (P = 0.45). In rural locations, there was a statistically significant decline in in-hospital mortality over the study period, from 12.1% in 2009 to 8.7% in 2014 (P = 0.004). Risk-adjusted mortality for those injured in a rural location was lower in 2013 than during 2009, but remained stable for those injured in metropolitan locations. CONCLUSION: Crude and risk-adjusted mortality after major trauma have remained stable in those injured in metropolitan areas of NSW between 2009 and 2014. The apparent downward trend in mortality associated with severe trauma in rural/regional locations requires further analysis.

PY - 2016 SN - 1326-5377 (Electronic)
0025-729X (Linking) SP - 403 EP - 407 ST - Med J Aust T2 - Medical Journal of Australia TI - Major trauma mortality in rural and metropolitan NSW, 2009-2014: a retrospective analysis of trauma registry data VL - 205 Y2 - FY17 ER -