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Using population-based critical care data to evaluate trauma outcomes.

Jan O Jansen1, Jonathan J Morrison2, Lorraine Smyth3

  • 1Department of Surgery and Intensive Care Medicine, Aberdeen Royal Infirmary, United Kingdom; Health Services Research Unit, University of Aberdeen, United Kingdom.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
|April 30, 2015
PubMed
Summary
This summary is machine-generated.

Critical care audit data can effectively analyze trauma mortality trends in Scotland. Despite increased admissions, trauma patient mortality rates requiring critical care unit admission remained stable over a decade.

Keywords:
APACHECritical care outcomeScotlandTrauma systems

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Area of Science:

  • Trauma Care Research
  • Critical Care Medicine
  • Public Health Surveillance

Background:

  • Mortality analysis is crucial for evaluating trauma care effectiveness.
  • General prediction models can adjust for case mix when specific data are unavailable.
  • Population-based trauma mortality analysis using critical care audit data is feasible.

Purpose of the Study:

  • To assess the feasibility of population-based trauma mortality trend analysis using critical care audit data.
  • To determine if critical care audit data can benchmark service reconfiguration impacts.
  • To investigate trauma mortality trends in Scotland from 2002-2011.

Main Methods:

  • Retrospective cohort study of adult trauma patients admitted to critical care units in Scotland (2002-2011).
  • Utilized nationally collected critical care audit data.
  • Standardized mortality ratios (observed vs. APACHE II predicted mortality) and linear regression for trend analysis.

Main Results:

  • Identified 4503 trauma patients.
  • Observed a significant annual increase in trauma admissions (p=0.011).
  • Actual mortality (11.6%) exceeded predicted in-hospital death probability (7%); no significant change in standardized mortality ratios (p=0.1224).

Conclusions:

  • Critical care unit audit data are feasible for analyzing trauma care outcomes.
  • This data approach can establish a baseline for evaluating future service reconfiguration.
  • Trauma patient mortality requiring critical care unit admission in Scotland showed little change, unlike systems with regionalized trauma care.