Trauma studies. II. A review of trauma in a Sydney metropolitan hospital

Trauma is the leading cause of death for people aged under 40 years in Australia. However, data on trauma in this country have been scant and derived from teaching hospitals or "non-medical" sources such as Roads and Traffic Authority reports. To address this, a review was undertaken of trauma separations from a large suburban hospital. The Nepean Hospital is a 350-bed metropolitan hospital on the western fringe of Sydney and, since the development of "Areas" as the basic health planning units in metropolitan Sydney, it is the main hospital of the Wentworth Area Health Service. A retrospective study of trauma presentations to the hospital was undertaken to provide a "snapshot" of the hospital's trauma load. Epidemiological factors leading to this load were reviewed, together with deaths, ambulance transfers and transfers by other means. During the study period there were 2042 separations for trauma based on the International Classification of Diseases codes E800-E999. Thirty-four other patients were transferred or died without being admitted to the hospital and 72 patients were transferred after hospital admission. During this period 1236 potentially severely injured patients were seen. This study demonstrates the large trauma load presenting to a Sydney suburban hospital and shows that planning for trauma services must take account of the size and logistics of such a load. As epidemiological indices suggest that the load will increase, further accurate data on suburban trauma are needed to allow proper planning.