遠隔地クイーンズランド州における重度外傷のパターンと転帰に関する遡及的レビュー

Trauma care in remote Australia faces persistent challenges due to workforce shortages, limited onsite specialties and the distance to a tertiary centre. Mount Isa Hospital (MIH), a Level II trauma facility, serves the North-West Queensland region; yet its trauma service performance remains underreported.

This study outlines the epidemiology, timelines of care and outcomes for Tier-1 trauma patients at MIH from 1 January 2018 to 30 June 2024. Key performance indicators were compared with metropolitan, other rural/remote hospitalsand national registry data to identify areas for improvement.

A retrospective review was conducted using the MIH Trauma data recorded under the State-wide Trauma Registry. Additional data were utilised for patients transferred to another hospital or health service. Demographics, mechanisms, anatomical injury patterns, interventions, inter-hospital transfers and 90-day mortality were collected.

Two hundred and eight patients met criteria. Motor-vehicle accidents (39.9%), assaults (23.6%) and mechanical falls (17.3%) predominated. Chest (40.4%) and head/neck (39.4%) were the most frequently identified "most-injured" regions. Definitive surgery was undertaken locally in 12.5%. Fifty-one percent required aeromedical transfer to tertiary centres, and 29.8% received surgical interventions there. 90-day mortality was 7.2%.

Although 90-day survival was comparable with national benchmarks, trauma care in North-West Queensland remains dependent on timely aeromedical retrieval to distant tertiary hospitals. Developing key strategies, staffing and education for damage-control surgery and critical care onsite, along with streamlined retrieval logistics, culturally safe First Nations-co-designed pathways, and robust trauma data collection is essential to provide appropriate care.