Injury in Auckland, New Zealand: an unexplored epidemic

The applicability of regionalization of injury care in New Zealand has not yet been investigated. In a first attempt to define the extent of the problem, all injured patients presenting to the resuscitation room in the emergency department of a large teaching hospital over a 1-year period were studied. Data on mechanism of injury, injury severity, resource utilization, management and outcome were recorded. A total of 602 patients was evaluated. Of these 37 per cent had Injury Severity Scores greater than or equal to 16 and 24 per cent were admitted to intensive care. Overall mortality was 10 per cent with the mean ISS for CNS related deaths being 39; for non-CNS related deaths, 46. The study confirmed that the characteristics of nonpenetrating injury in New Zealand were similar to the USA. Extrapolating from US data, one could anticipate that up to 30 per cent of deaths following injury in NZ annually may be preventable. If regionalization could reduce this rate to just 10 per cent, 360 lives could be saved annually with a contribution of $8 million to the GNP and $2.2 million to the annual government tax accounts.