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Performance of a prehospital trauma diversion system in Hong Kong, China
Tak-Wai Lui1, Kit-Ling Fan, Ling-Pong Leung
1Department of Medicine, Queen Mary Hospital, Hong Kong, China.
Insights
Hong Kong
Area of Science:
- Trauma care systems
- Emergency medicine
- Public health policy
Background:
- Effective prehospital trauma diversion systems are crucial for optimizing patient outcomes.
- Accurate identification of patients requiring specialized trauma center care is essential.
Purpose of the Study:
- To evaluate the performance of the prehospital trauma diversion system in Hong Kong.
- To determine the accuracy of the current trauma patient diversion protocol.
Main Methods:
- Retrospective analysis of prospectively collected trauma registry data (2009-2013).
- Inclusion of adult patients (≥18 years) diverted to Queen Mary Hospital.
- Assessment of diversion accuracy based on need for trauma center level of care.
Main Results:
- 209 patients analyzed; 30% required trauma center care.
- High over-diversion rate (69.6%) and significant under-diversion rate (19.7%).
- Common reasons for diversion included need for urgent surgery.
Conclusions:
- The current trauma patient diversion protocol in Hong Kong demonstrates suboptimal accuracy.
- The protocol requires significant revision and refinement to improve its effectiveness.
Purpose:
To evaluate the performance of a prehospital trauma diversion system in Hong Kong, China.
Methods:
A retrospective analysis of prospectively collected data in the trauma registry of Queen Mary Hospital, Hong Kong from 1 January 2009 to 31 December 2013 was done. All adult patients aged 18 years or above, either primarily or secondarily diverted to Queen Mary Hospital according to the trauma patient diversion protocol, were recruited. Need for trauma center level of care was based on a consensus-based criterion standard published in 2014. Performance of the protocol in terms of over- diversion and under-diversion was determined.
Results:
A total of 209 patients were included for analysis. About 30% of the patients required trauma center level of care. The most common reason was the need for vascular, neurologic, abdominal, thoracic, pelvic, spine or limb-conserving surgery within 24 h of presentation. The over-diversion rate and under- diversion rate were 69.6% and 19.7% respectively.
Conclusion:
The trauma patient diversion protocol currently in use in Hong Kong is not accurate enough. Further revision and refinement is needed.
