Trauma mortality and trauma center designation: an international comparison

In order to compare trauma mortality of a designated Level I Trauma Center in the United States with a major metropolitan hospital in New Zealand, patients presenting to these institutions were reviewed. Over a 1 year period 824 patients (62 deaths) presented to the Southern New Jersey Regional Trauma Center (SNJRTC) and 602 (60 deaths) to the Resuscitation room at Auckland Hospital (AH). There were no differences between age or severity of injury in those patients dying at the two institutions but brain injury was significantly more common a cause of death at Auckland Hospital (P less than 0.001). At SNJRTC exsanguination was significantly more common (P less than 0.05) and patients were more likely to die in the admitting area (P less than 0.01). The results confirm the similarity of the trauma mortality between a major metropolitan hospital in New Zealand and a United States Level I Trauma Center dealing primarily with blunt trauma. Effectiveness of trauma care in the two locations as judged by the average Injury Severity Score of CNS and non-CNS related deaths, is comparable. This suggests that despite not being completely equipped as a Level I Trauma Center the commitment to caring for patients at the New Zealand hospital is an important factor affecting the outcome.