Please use this identifier to cite or link to this item:
http://hdl.handle.net/11054/235
Title: | The major trauma management study: an analysis of the efficacy of current trauma care. |
Authors: | Walker, Stephen Danne, Peter Brazenor, Graeme Cade, Richard Crossley, Peter Fitzgerald, Mark Gregory, Peter Kowal, Diane Lovell, Lynette Morley, Peter Smith, Mark Taylor, Russell |
Issue Date: | 1998 |
Publisher: | Wiley |
Place of publication: | Melbourne |
Publication Title: | ANZ Journal of Surgery |
Volume: | 68 |
Issue: | 1 |
Start Page: | 50 |
End Page: | 57 |
Abstract: | BACKGROUND: An audit of the management and outcome of major trauma patients was carried out to determine ways in which the system of care may be improved. METHODS: The Major Trauma Management Study (MTMS) collected data prospectively on all consecutively admitted major trauma patients at eight major hospitals during a 12-month period. Outcome was studied using trauma and injury severity score (TRISS) and a severity characterization of trauma (ASCOT) analyses, as well as a preventable outcome analysis, which looked at survivors with complications or with a Glasgow Coma Score < 15 on discharge from hospital, as well as studying deaths. RESULTS: The group of 859 patients was more severely injured than most described previously, with a mortality of 14.8% and a mean injury severity score of 19.8. Formal ASCOT analysis indicated 2.25% fewer survivors than would be predicted by Major Trauma Outcome Study norms. Extrapolating the TRISS and ASCOT process to include those patients with missing data, and then comparing groups of matched severity with the norms, gave no statistically different outcome in the MTMS group of patients. Preventable outcome analysis revealed rates of preventable and potentially preventable (P/PP) outcomes of 32% among deaths and 8% among survivors. The types of management deficiencies responsible for P/PP outcomes are identified. CONCLUSIONS: The points of deficiency in a system of care have been identified, and the development of an integrated trauma system in Victoria, based upon these facts, is recommended. Children, the elderly, patients with head injuries and patients being transferred between hospitals would benefit from improvements to the system of care. The calculation of efficacy rate (0.95 for the MTMS patients) is recommended to accurately assess the system of care. Preventable Outcome Analysis is more relevant to auditing a system of trauma care in detail, than is ASCOT or TRISS. The MTMS has refined and defined the process so that it is reproducible in further comparative studies. |
URI: | http://hdl.handle.net/11054/235 |
Resource Link: | http://onlinelibrary.wiley.com/doi/10.1111/j.1445-2197.1998.tb04637.x/pdf |
ISSN: | 1445-1433 |
Internal ID Number: | 00217 |
Health Subject: | ASCOT EFFICACY RATE INTERGRATED TRAUMA SYSTEM MAJOR TRAUMA PREVENTABLE OUTCOME ANALYSIS TRISS |
Type: | Journal Article Article |
Appears in Collections: | Research Output |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.