The major trauma management study: an analysis of the efficacy of current trauma care

The Australian and New Zealand Journal of Surgery
P DanneS Walker

Abstract

An audit of the management and outcome of major trauma patients was carried out to determine ways in which the system of care may be improved. The Major Trauma Management Study (MTMS) collected data prospectively on all consecutively admitted major trauma patients at eight major hospitals during a 12-month period. Outcome was studied using trauma and injury severity score (TRISS) and a severity characterization of trauma (ASCOT) analyses, as well as a preventable outcome analysis, which looked at survivors with complications or with a Glasgow Coma Score < 15 on discharge from hospital, as well as studying deaths. The group of 859 patients was more severely injured than most described previously, with a mortality of 14.8% and a mean injury severity score of 19.8. Formal ASCOT analysis indicated 2.25% fewer survivors than would be predicted by Major Trauma Outcome Study norms. Extrapolating the TRISS and ASCOT process to include those patients with missing data, and then comparing groups of matched severity with the norms, gave no statistically different outcome in the MTMS group of patients. Preventable outcome analysis revealed rates of preventable and potentially preventable (P/PP) outcomes of 32% among deaths and 8% among sur...Continue Reading

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Sep 3, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·J KimM A Dexter
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