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Risk of Death among Cases Attending South Australian Major Trauma Services after Severe Trauma: The First 4 Years of Operation of a State Trauma System

Brennan, Peter W. BSc(Med), MBBS; Everest, Evan R. MB, ChB, BSc, FRACP; Griggs, William M. FFICANZCA, Dip AV Med; Slater, Anthony MB, BS, FRACP; Carter, Libby RN, BNsg, Grad Dip Pub Health; Lee, Christine RM, BNsg; Semmens, Julie K. RN, BNsg; Wood, Debra J. RN, BNsg; Nguyen, Anh-Minh T. BSc(Hons); Owen, Dorothy L. RN, Dip App Sc; Pilkington, Prudence RN, BNsg; Roder, David M. DDSc, MPH; Somers, Ronald L. PhD, MPH

Journal of Trauma-Injury Infection & Critical Care:
Original Articles
Abstract

Background : Factors predictive of death at South Australian major trauma services were investigated among 8,654 patients who had experienced severe trauma from 1997 to 2000.

Method : Univariate and multivariate analyses of age, sex, injury severity, presence of comorbid conditions, and calendar year of presentation were performed.

Results : Multiple logistic regression indicated that factors predictive of death were older age; higher injury severity as indicated by the New Injury Severity Score and the Revised Trauma Score; and accompanying chronic liver disease, ischemic heart disease, and chronic renal failure. A decrease in risk of death by calendar year was statistically significant (p = 0.001). Using 1997 as the reference, the relative odds of death were 0.86 (95% confidence limits) (0.53, 1.39) for 1998, 0.60 (0.36, 0.99) for 1999, and 0.45 (0.27, 0.76) for 2000.

Conclusion : Results show a decrease in risk of death of patients attending South Australian major trauma services, from injuries of equivalent severity, during the first 4 years of operation of the State Trauma System.

Author Information

From the Master of Applied Epidemiology (Disease Control) Program, National Centre for Epidemiology and Population Health, The Australian National University (P.W.B.), Canberra, Australian Capital Territory, Trauma Services, Flinders Medical Centre (E.R.E., D.J.W.), Trauma Services, Royal Adelaide Hospital (W.M.G., L.C., C.L.), South Australian Trauma Registry (D.L.O., P.P.), Epidemiology Branch (A.-M.T.N., D.M.R.) and Injury Surveillance and Control Unit (R.L.S.), Department of Human Services, Adelaide, and Paediatric Trauma Service, Women’s and Children’s Hospital (A.S., J.K.S.), North Adelaide, South Australia, Australia.

Submitted for publication April 22, 2001.

Accepted for publication January 23, 2002.

The State Trauma Registry is funded by the South Australian Department of Human Services.

Address for reprints: David Roder, DDSc, MPH, Epidemiology Branch, P.O. Box 6, Rundle Mall, Adelaide, SA 5000, Australia; email: droder@cancersa.org.au.

© 2002 Lippincott Williams & Wilkins, Inc.