Trends in Procedures at Major Trauma Centres in New South Wales, Australia: An Analysis of State-Wide Trauma Data.

Abstract

To describe the trend in major trauma surgical procedures and interventional radiology in major trauma patients in Australia over the past 6 years. This was a retrospective review of adult major trauma (Injury Severity Score greater than 15) patients using the New South Wales Statewide Trauma Registry between 2009 and 2014. Major trauma surgical procedures were classified into abdominal, neurosurgery, cardiothoracic and interventional radiology. The proportion of patients undergoing such procedures per year was the outcome of interest. There were around ten thousand cases analysed. The proportion of cases undergoing interventional radiology procedures increased from 1% in 2009 to around 6% in 2014. Other major trauma surgical procedures remained stable. Only around 100 laparotomies were performed in 2014. The predictors of having an IR procedure performed were increasing from 2009 (OR 1.5 95% CI 1.4, 1.6 p<0.001), hypotension (OR 1.5 95% CI 1.1, 2.1 n=0.01), severe abdominal injury (OR 4.2 95% CI 3.2, 5.3 p<0.001) and lower limb (including pelvic) injury (OR 3.8 95% CI 3.0, 4.7 p<0.001). There has been a rapid increase in the use of interventional radiology over the past few years which will need to be addressed in future trauma service planning and models of care.