People who survive severe trauma, the leading cause of death worldwide for people under 45, have improved chances of long-term recovery if treated in highly specialised trauma hospitals, according to new research.
In a study of outcomes for survivors of severe trauma managed in an organised trauma system, researchers found that trauma systems and high-level trauma centre care improved both mortality rates and long-term injury-related impairment in patients.
Detailed in the Annals of Surgery this month, the research, led by Associate Professor Belinda Gabbe from Monash University’s Department of Epidemiology and Preventive Medicine, evaluated the functional outcome of 4986 adult major trauma patients in the Victorian State Trauma Registry (VSTR) for the period 2006 to 2009.
The large-scale study was the first to examine the 12-month functional outcomes of major trauma patients managed in the Victorian State Trauma System (VSTS), which coordinates pre-hospital services and acute care across the state.
Associate Professor Gabbe said the findings demonstrated the value and importance of trauma systems as a public health priority.
“Despite an annual decline in mortality, functional outcomes improved over time, and cases managed at specialist trauma centres demonstrated better functional outcomes,” Associate Professor Gabbe said.
“The findings provide evidence that this inclusive, regionalised trauma system – VSTS – is achieving its aim to reduce preventable deaths and disability.
“At Major Trauma Service (MTS) hospitals, the experience and staffing levels of medical, surgical and allied health are likely to contribute to the improved functional outcomes of MTS-managed major trauma cases.”
The cost of trauma care for survivors and the burden to society can be seen in terms of pain suffering, loss of wages and permanent or long-term disability.
The study found, at 12 months from injury, 80 per cent of major trauma survivors continued to experience disability, with 35 per cent achieving good recovery, meaning injury had not affected function in major life areas. Seven per cent had died since discharge from hospital.
The VSTR is an initiative funded and approved by the Department of Health (Victoria) and TAC Health Research.