Trauma patient outcomes after the implementation of a trauma admitting service: a pre-post cohort study

Abstract

Aims: Injury is the leading cause of death for those under 35 years in New Zealand, with major trauma (Injury Severity Score >12) accounting for 2,409 cases in 2021/2022. There is evidence of improved outcomes with specialised trauma care including dedicated trauma admitting teams. Christchurch Hospital introduced a minimally resourced trauma admitting service (TAS) in January 2022. This study evaluates the impact of the implementation of a TAS on the outcomes of major trauma patients.

Methods: A pre-post cohort study compared major trauma patient outcomes at Christchurch Hospital 1 year before and after TAS implementation.

Results: The study included 773 patients-356 pre-TAS and 417 post-TAS. Patient characteristics were similar across both cohorts. No significant differences were found between pre- and post-TAS groups in hospital LOS (7 vs 8 days, p=0.558), in-hospital mortality (6% vs 7%, p=0.774), 30-day mortality (6% vs 7%, p=0.764) or tertiary survey completion (60% vs 60%, p=0.853).

Conclusion: The introduction of the TAS at Christchurch Hospital did not yield objective improvements in major trauma outcomes. Limitations in coverage and staffing may have impacted effectiveness, highlighting the need for better resources and larger studies for further analysis.