Citation

Deasy C, Gabbe B, Palmer C, Babl FE, Bevan C, Crameri J, Butt W, Fitzgerald M, Judson R, Cameron P. Injury 2012; 43(12): 2006-2011.

Affiliation

Monash University, Department of Epidemiology and Preventive Medicine, Australia; The Alfred Hospital, Melbourne, Australia.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.injury.2011.08.032

PMID

21978766

Abstract

BACKGROUND: The aim of this study was to establish the profile and outcomes of paediatric major trauma care (PTMC) within an integrated inclusive regionalised trauma system. METHODS: Prospectively collected data from July 2001 to June 2009 from the Victorian State Trauma Registry of patients aged <18 years were reviewed. RESULTS: There were 1634 major trauma cases with a median (IQR) age of 13 (6-16) years and 69% were male. The median ISS (IQR) was 18 (16-26). There were 1361 patients treated at a major trauma centre of which 69% (n=943) were treated at the PMTC. Head injury (AIS>2) was the most frequent injury (n=950, 58%). Surgery was required in 39% (n=637) of all cases; 437 patients in the 10-17 year old group and 200 patients in the 0-9 year old group; the mortality was 6.6%. There were 530 patients (32.4%) ventilated in ICU; these had a median ISS (IQR) of 25 (17-34) and mortality of 7.4%. Improvements in risk-adjusted mortality have occurred as the years have progressed [adjusted OR 95% CI: 0.87 (0.76, 0.99)] and being treated at a Level 1 trauma centre was associated with lower adjusted odds of mortality [adjusted OR 95% CI: 0.27 (0.11, 0.68)]. CONCLUSION: The establishment of this integrated inclusive regionalised trauma system has been associated with progressively improving risk-adjusted mortality. The relatively low volume of major trauma requiring surgery in the 0-9 year old age group is notable, creating a challenging environment for maintaining skills and institutional preparedness.

Language: en