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The NSW Trauma Registry Profile of Serious to Critical Injuries: 2006

INSTITUTE OF

TRAUMA AND INJURY

MANAGEMENTNE W

S OU

TH W

AL ES

The NSW Trauma Registry Profile of Serious to Critical Injuries

2006

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Suggested citationNew South Wales Institute of Trauma and Injury Management. The NSW Trauma Registry Profile of

Serious to Critical Injuries: 2006. 2007. NSW Health

Prepared by

David Martens

NSW Trauma Data Manager

New South Wales Institute of Trauma and Injury Management

Any enquiries about or comments on this publication should be directed to:

Trish McDougall

Executive Manager

© NSW Institute of Trauma and Injury Management

PO Box 6314

Level 3, 51 Wicks Road

NORTH RYDE NSW 2113

Phone: 02 9887 5726

Fax: 02 9887 5843

International: +61 2 9887 5726

Email: itim@nsccahs.health.nsw.gov.au

Website: www.itim.nsw.gov.au

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NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries 2006 i

acknowledgements The NSW Institute of Trauma and Injury Management would like to thank the staff of trauma services at the following hospitals for their expertise, data collection, support and enthusiasm in the collection of the NSW Trauma Minimum Data Set.


• Gosford Hospital
• John Hunter Hospital / John Hunter Children’s Hospital
• Liverpool Hospital


• Nepean Hospital


• Prince of Wales Hospital


• Royal North Shore Hospital


• Royal Prince Alfred Hospital


• St George Hospital


• St Vincent’s Hospital


• Sydney Children’s Hospital


• The Children’s Hospital at Westmead


• Westmead Hospital


• Wollongong

ii ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries 2006 NSW Health

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries 2006 iii

Acknowledgements................................................... i

Executive Summary..................................................1 Overview ......................................................................1

The NSW Trauma System ..............................................1

The NSW Trauma Registry .............................................3

How complete is the dataset? .......................................3

Why is this data important? ..........................................4

Injury Severity Scores .....................................................5

Defi nitive trauma care ...................................................5

People and admissions ..................................................5

How data in this report is used ......................................6

Key Points .....................................................................6

Data Summary...........................................................7 Total injured people and admissions ..............................7

Trauma centre admissions .............................................8

Area Health Services .....................................................9

Age distribution ..........................................................10

Mechanisms of injury ..................................................11

Admission type ...........................................................12

Intensive care ..............................................................13

Hospital length of stay ................................................14

Arrival mode ...............................................................14

Surgical procedures .....................................................15

Times and Days of Week .............................................16

Injury Severity Score and body regions.........................17

Times to Defi nitive Care ..............................................18

Contents

Focus on low/medium falls (<5m).........................20 Focus on Pedestrians.............................................29 Individual Trauma Service Summaries.................36 Gosford Hospital .........................................................36

John Hunter Hospital/John Hunter Children’s Hospital .40

Liverpool Hospital .......................................................45

Nepean Hospital .........................................................49

Prince of Wales Hospital ..............................................53

Royal North Shore Hospital .........................................57

Royal Prince Alfred Hospital ........................................61

St George Hospital ......................................................65

St Vincent’s Hospital ....................................................69

Sydney Children’s Hospital ..........................................73

The Children’s Hospital at Westmead ..........................77

Westmead Hospital .....................................................81

Wollongong Hospital ..................................................85

Appendix..................................................................89 Index of Tables........................................................90 Index of Figures......................................................93

iv ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries 2006 NSW Health

Overview

In 2006, 2386 people were admitted to Trauma centres

in NSW after sustaining injuries classifi ed as serious to

critical. Although this was only a small increase from the

2005 fi gure of 2,314 people, the numbers in this group

have been steadily rising since the establishment of the

NSW Trauma Registry in 2002. In that year, the total

number of people was 1,781.

The steady growth is largely refl ected in a consistent

annual rise in the numbers of people sustaining injuries

due to road trauma, and due to falls1. Most notable in

these groups in 2006 has been the increase in trauma

due to low/medium falls (<5m), and an increase in

trauma due to pedal cycle, pedestrian and motorcycle

crashes.

There are also more positive signs in the 2006 data. The

overall fatality rate for all patients in 2006 fell slightly

to 12.6%, from 13.4% in 2005. Another good sign has

been a small fall in the numbers of people sustaining

injuries in motor vehicle crashes.

This report is the fi fth in the series of NSW Trauma

Registry Profi les of Serious to Critical Injuries published

by the NSW Institute of Trauma and Injury Management2

(NSW ITIM). Familiar tables and fi gures are provided to

illustrate the 2006 data, and to enable comparison of

data with previous year’s reports.

New to this report is an Area Health Service profi le.

This data expands upon the picture of trauma in

NSW provided in this report, allowing for a better

understanding of where injuries occur and how the NSW

trauma system responds to these patients.

The NSW Trauma System

The NSW trauma system consists of an organised

approach to facilitate and coordinate a multidisciplinary

system response to provide care to injured patients. The

system encompasses a continuum of care that provides

injured people with the greatest likelihood of returning to

their prior level of function within the community.

This continuum of care includes injury prevention, pre

hospital coordination and care, appropriate triage and

transport, emergency department trauma care, trauma

centre team activation, surgical intervention, intensive/

critical and general in-hospital care, rehabilitation

services, allied health and medical care follow up.

The overall goal of the NSW State Trauma System is to

decrease the incidence and severity of injury; as well

as to ensure optimal and accessible care to improve

health outcomes for those who are injured. Furthermore

the trauma system aims to facilitate the treatment of

the ‘right patient at the right hospital’, ensuring that

designated trauma centres have appropriate resources to

meet the complex needs of the injured patient.

Within NSW Health there are defi ned lines of

responsibility and accountability for care of the injured

patient within the trauma system. The clinical structure is

comprised of:

J Out of Hospital

The management of serious to critical trauma in NSW

is guided by the Ambulance Service of NSW (ASNSW)

Protocol 4 early notifi cation and bypass system. This

system has been designed to facilitate the delivery of

patients to a hospital where meaningful interventions

can be undertaken in the shortest possible time.

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries 2006 1

1 A small increase in numbers can also be attributed to the addition of trauma patient data from Gosford Hospital from 2003 onward, and from Wollongong Hospital

from 2004 onward

2 Earlier reports in this series were published annually with the title:NSW Institute of Trauma and Injury Management (ITIM) Trauma Minimum Data Set Annual Report

Executive Summary

2 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries 2006 NSW Health

In the metropolitan areas this involves bypassing non-

trauma designated hospitals. In rural areas it involves

the early notifi cation through ambulance operations

centres and the NSW Aeromedical and Medical Retrieval

Service (AMRS) to allow planning of retrieval and support

services to a place of intervention3;

J Hospitals

A three tiered level of care exists within the greater

metropolitan area and the rural areas of the state,

provided by Major Trauma Services, Regional Trauma

Services and Urban Trauma Services, Rural Referral

Trauma Services and Rural Designated Protocol 4 and

Non-designated Protocol 4 Trauma Services;

J State-wide Specialist Services

Spinal Cord Injury & Severe Burn Injury Service4;

J Rehabilitation Services including Brain Injury

Rehabilitation Services.

Out of Hospital

An injured patient may be delivered to the trauma

system in two ways:

J Non-ambulance arrival occurs when the patient

arrives at a hospital outside of the ambulance/

emergency services arrangements. For example a

patient may arrive at hospital by private vehicle;

J Ambulance/helicopter arrival occurs after the patient

has been subjected to a Trauma Triage process

whereby a decision is reached which determines

which hospital is the most appropriate for the

patient.

The pre-hospital phase of care is the period from the time

of injury to arrival at a defi nitive care trauma hospital.

The appropriate identifi cation of patients with serious

injury and their timely arrival at an appropriate hospital

are crucial to the effectiveness of the trauma system.

In NSW the pre-hospital management of serious to critical

trauma is guided by the Ambulance Service of NSW

(ASNSW) Protocol 4 early notifi cation and bypass system.

The purpose of Pre hospital Trauma Triage is to provide a

statewide, structured protocol driven process

for patients meeting the criteria defi ning serious trauma

to receive an appropriate emergency response and

transport to the appropriate level trauma facility within

the least time interval possible. By preference this will be

direct transport from the scene or by the most effi cient

retrieval means possible.

Protocol 4 is aligned to the Early Notifi cation of Severe

Trauma (NSW Health Circular 2002/105) for rural area,

involving the early notifi cation through ambulance

operations centres and the NSW Aeromedical and

Medical Retrieval Service (AMRS) to allow the appropriate

mobilisation of clinical resources.

Hospitals

Upon arrival at a hospital patients undergo a systematic

assessment of their injuries. Injury diagnosis, treatment

and progress through the hospital are planned and

monitored.

If deemed necessary a patient may require transfer

to a more appropriate level of service within the

trauma system. Injured patients progress to recovery,

rehabilitation and discharge in a timely fashion with

appropriate referral to post acute care as required.

Patients with major trauma are likely to be directly

admitted or transferred to a major trauma service in

NSW. Major trauma, the key focus of this report5, refers

to patients with multiple injuries requiring complex

multidisciplinary management or single system injuries of

a potentially life-threatening nature or which will require

complex management at specifi cally designated and

equipped health facilities.

A major trauma service can provide the full spectrum

of care for the most severely injured trauma patient,

from initial resuscitation through to discharge and

rehabilitation.

The major trauma service provides leadership, education,

research and promotes a cooperative and collaborative

working environment among the clinical disciplines

involved in trauma care. The major trauma service

provides expert care for injured patients, coordinating

3 In 2002 the revised document ‘Early Notifi cation of Severe Trauma in Rural New South Wales’ was released with the aim to improve the management and the

outcomes for patients severely injured in rural NSW. All rural hospitals must have in place written protocols for the recognition, notifi cation and response to severe

trauma in rural areas. (See: NSW Health Circular 2002/105). 4 See also NSW Health Policy Directive - Critical Care Adult Tertiary Referral Networks 2006 (Doc No. PD2006_046), which defi nes links between Area Health Services

and tertiary referral hospitals. The policy also defi nes clinical super-specialty referral networks including the NSW Severe Burn Injury Service (Adult), NSW Acute

Spinal Cord Injury Referrals (Adult), and NSW Major Trauma Referrals (Adult). 5 ‘Major trauma’ is a term also used to refer to patients with serious to critical injuries.

Executive Summary

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries 2006 3

the care of multiple specialty teams and advocating for

patients, both within the acute in hospital phase and

during rehabilitative care.

In the initial phase, all major trauma patients are

transported to a major trauma service for assessment,

resuscitation and initiation of defi nitive trauma care.

The service also reviews all trauma patients following

admission and perform a tertiary service and radiology

review.

State-wide Specialist Services

A number of statewide clinical super-speciality networks

operate in tandem with the NSW Critical Care Tertiary

Referral Networks (Adults).

These networks are largely determined by the location

of the clinical super-specialty services, and in some cases,

the imperative to achieve early clinical intervention such

as for those patients with major trauma.

1. NSW Severe Burn Injury Service (Adult)

The NSW Severe Burn Injury Service (Adult) is part of

the Statewide Severe Burn Service Network located at

Concord Repatriation General Hospital and Royal North

Shore Hospital. Children requiring attention for severe

burn injury are cared for at The Children’s Hospital at

Westmead.

2. NSW Acute Spinal Cord Injury Service (Adult)

The NSW Acute Spinal Cord Injury Service (Adult) is

located at the Prince of Wales Hospital and the Royal

North Shore Hospital. The State Spinal Cord Injury Service

(SSCIS) is responsible for the management of adults

who have sustained a spinal cord injury, with evidence

of damage to the neural tissues as a result of trauma, or

from a non-progressive disease process (eg. transverse

myelitis, vascular occlusion, compression by infective

process or haemorrhage).

3. Brain Injury Rehabilitation

The needs of patients with brain injury are complex and

often require long term therapy. Brain injury rehabilitation

units at Royal Rehabilitation Centre, Sydney, Westmead

and Liverpool Hospitals provide highly specialised adult

in-patient care. Paediatric in-patient services are provided

at the Children’s Hospital, Westmead and at the Sydney

Children’s Hospital.

The NSW Trauma Registry NSW ITIM is responsible for managing the collection of

data about seriously to critically injured people admitted

to trauma centres in NSW. Data collected about these

patients is held securely in the NSW Trauma Registry.

Data in the registry is submitted regularly from Trauma

Registries at each NSW trauma centre6.

The data submitted from each Trauma Registry describes

patients admitted to the trauma centre whose injuries are

classifi ed from serious to critical according to an Injury

Severity Score calculated by accredited trauma centre

staff. More information about Injury Severity Scores is

provided below.

The NSW Trauma Registry contains simple, non-

identifi able information about each injured person, the

nature and location of the incident resulting in injury,

the main injuries sustained, and details of pre-hospital

and in-hospital treatments and services provided to each

person. In addition, some data about other (earlier)

hospital admissions is collected for patients transferred to

a trauma centre for trauma services7. The data collection

tool from which this data is derived is included in

Appendix 1.

How complete is the dataset? The data held in the NSW Trauma Registry represents the

great majority of people who sustained serious to critical

injuries within NSW. More specifi cally, the data represents

an almost complete record of admissions of seriously to

critically injured patients admitted to trauma centres in

NSW. There are however known instances where data

about seriously to critically injured patients is not held in

the NSW Trauma Registry.

In general, the data represents residents of NSW who

were injured in NSW and who were consequently

admitted to a Trauma Centre in NSW. The data may also

include some patients who were injured outside NSW, or

who are residents outside NSW, who were admitted to a

Trauma Centre in NSW.

No data is currently available to NSW ITIM however

regarding injured people who were not admitted to

trauma centres in NSW, as data is only currently collected

for the NSW Trauma Registry at these centres.

6 Currently includes trauma registries at Gosford Hospital, John Hunter/John Hunter Children’s Hospital, Liverpool Hospital, Nepean Hospital, Prince of Wales Hospital,

Royal North Shore Hospital, Royal Prince Alfred Hospital, St George Hospital, St Vincent’s Hospital, Sydney Children’s Hospital, Westmead Hospital, The Children’s

Hospital at Westmead and Wollongong Hospital 7 The trauma data collection tool from which this data is derived is provided at Appendix 1

Executive Summary

4 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries 2006 NSW Health

Consequently, data is not currently collected about

seriously to critically injured people who were admitted

to other hospitals in NSW. Although it is likely that this

group of patients is very small, NSW ITIM recognises that

the lack of specifi c data to support evaluation of system

access by patients injured in the rural environment is an

area that needs attention.

A NSW Rural Trauma Clinical Nurse Consultant Pilot

Project has been developed which will enable prospective

data collection identifying the spectrum of serious

trauma admissions to hospitals in a rural region, including

in-hospital deaths and patients who are transferred or

taken directly from the scene to Trauma Centres in the

metropolitan areas.

The pilot project after appropriate evaluation will enable

a process which could be adapted in other areas to

provide data, monitoring of patient outcomes and

trauma system function in rural areas of NSW. The pilot

project will commence in 2007.

Data is also currently unavailable for people who may

have been injured in NSW and admitted or transferred

to a hospital outside NSW. The effect of this is most

noticeable for areas of NSW near state borders, such as

the far north or far south of NSW, or districts adjacent

to the Australia Capital Territory. NSW ITIM is currently

collaborating with the Shock Trauma Team at Canberra

Hospital and hopes to present data from that hospital in

future reports.

Why is this data important? The numbers of patients described in this report are

relatively small in contrast to the large numbers of

people admitted to hospital or attending emergency

departments in NSW hospitals following traumatic injury.

This group of seriously to critically injured patients,

however, is resource intensive, and may require the

utilisation of numerous health and community services,

multiple government and non-government agencies,

insurers, legal practitioners, employers, unions and

others. While many health services will assist these

patients in the immediate acute phase following injury,

other needs and relationships will be long term, and

ongoing.

In the acute period immediately following injury,

these patients may require extensive pre-hospital and

emergency services - including the services of other

government agencies such as police and rescue services.

They will frequently require a range of coordinated

services from hospital emergency departments and

trauma teams, surgical services and intensive care units.

They will often require extensive assistance from allied

health professionals.

They may need extensive rehabilitation and a range of

community services in order to return home. Others

may need ongoing support from health and community

services for the rest of their lives. In many cases an injury

will affect an injured person’s ability to work and live

independently, often impacting on lives beyond that of

the injured person.

Costs associated with this group of patients are

therefore extensive. A large number of these patients are

entitled to compensation, and may be engaged in legal

proceedings or in long-term relationships with insurers

following their injury. For others without recourse to

compensation, the costs of treatment, rehabilitation and

long term care and support are provided by government

agencies.

Identifying and understanding the nature of trauma

through these patients is critical to determining

prevention and treatment strategies, as well as gearing

the trauma system to provide the best possible response

to trauma where and when it occurs.

Executive Summary

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 5

Injury Severity Scores

Major trauma patients, the key focus of this report, are

defi ned as those with either a severe injury or a risk

for severe injury with an Injury Severity Score (ISS) >15,

recognised as an indicator of serious injury.

ISS scoring is undertaken retrospectively, but within 24-48

hours after admission to allow for identifi cation of all

injuries. On initial evaluation these patients typically have

abnormal vital signs or a signifi cant anatomical injury.

Patients with an ISS >15 represent approximately 2.4%

of total trauma related admissions to NSW hospitals.

The Injury Severity Score (ISS) is an anatomical scoring

system that provides an overall score for patients with

multiple injuries. The ISS is a calculated number which

is based on an anatomical injury severity classifi cation,

the AIS or Abbreviated Injury Scale8. The AIS classifi es

individual injuries by body region on a 6 point severity

scale from Minor to Maximum (currently untreatable

injury).

The ISS score is an internationally recognised anatomical

scoring system which correlates linearly with mortality,

morbidity and other measures of severity. ISS is best

reported in ranges – for this report: 16-24 (serious injury),

25-40 (severe injury) and 41-75 (critical injury).

Defi nitive trauma care

Defi nitive care is a key factor determining optimal patient

outcome. The hospital of defi nitive care is considered

to be the hospital where a patient is provided with all

treatment and care required for their injuries.

Although a patient may be admitted to a hospital for

treatment of an injury, specialist treatment or facilities

may require transfer to a trauma service for defi nitive

care, for example a child may be transferred to a

children’s hospital for specialised defi nitive care.

The hospital of defi nitive care is referred in this report as

the defi nitive trauma hospital. Figures in this report which

refer to defi nitive care have been adjusted to account for

any transfers from other hospitals or trauma centres.

People and admissions In 2006 there were 2,482 admissions to trauma centres

in NSW. There were however 2,386 people who

sustained serious to critical injuries in NSW.

The different fi gures refl ect a great strength of the NSW

Trauma Registry – the ability to trace the progress of

trauma patients through the NSW trauma system.

When a patient is transferred from one trauma centre to

another, the NSW Trauma Registry records the transfer

as an additional hospital admission for that patient. The

number of patients remains as it is – only one person has

been injured - but an additional record has been created

for the additional admission9.

This feature of the NSW Trauma Registry allows for

counts of distinct people, generally referred to as ‘people

injured’ in the report, to be distinguished from counts of

hospital admissions. By defi nition, the number of hospital

admissions is always equal to or greater than the number

of people injured.

Generally, numbers of injured people are used in this

report to describe people, their injuries and how, when

and where they sustained them, while numbers of

admissions are used to describe pre-hospital and in-

hospital treatments and services.

8 Abbreviated Injury Scale: Association for the Advancement of Automotive Medicine, 1990 Update, ’98 Revision. 9 Admissions to hospitals other than trauma centres are generally not included in admission fi gures in this report unless specifi cally mentioned.

Executive Summary

6 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

10 Death rates in this report are case fatality rates, calculated as follows: Case fatality rate = number of deaths divided by the number of patients in this data collection X 100 11 Assaults in the NSW Trauma Registry include blunt assault, shootings and stabbings

How data in this report is used Data from the Trauma Minimum Data Set is used to provide advice and feedback to clinicians and other

stakeholders, and enables research into patterns of service demand and staffi ng. This data also supports

benchmarking and performance improvement activities. In addition it is used in the following important areas

of practice: J Provides information to NSW Health, Area Health Services, Injury Prevention Groups, Motor Accidents

Authority, Road Traffi c Authority and other appropriate organisations

J Supports current and future trauma service planning in NSW

J Identifi es specifi c areas of need for Education programs to be used by pre hospital providers, clinicians,

administrators and consumers

J Illustrates the Rural – Metropolitan trauma transfer patterns

J Is a resource for the development of identifi ed Clinical Practice Guidelines

J Assists in the evaluation of inter rater reliability Scoring Systems across the trauma environment

J Recommends topics for potential research projects

J Contributes to the National Trauma Registry Consortium

Key Points

Much of the data presented in this report is consistent with data from previous years: for example age distributions, major mechanisms of injury (road trauma, falls, assaults), and gender distributions show little variation in data collected from 2002-2006;

The death rate10 for serious to critically injured people fell to 12.6%, from 13.4% in 2005;

The number of people injured due to motorcycle crashes, pedestrian injuries, pedal cycle injuries, and low to medium falls (<5m) increased in the year from 2005 to 2006;

Injured pedestrians in 2006 were more frequent in younger age ranges (particularly aged 15-24 years), with proportionally more critical injuries than other mechanisms of injury, a higher than average death rate, and were most frequently injured in South Eastern Sydney/Illawarra Area Health Service districts;

People injured following low/medium falls were more commonly aged 65 years and over, and were injured in Northern Sydney/Central Coast Area Health Service districts. The death rate for low/medium falls was particularly high for these older age groups;

Hunter/New England Area Health Service and Sydney West Area Health Service treated more major trauma due to road trauma than any other area health service;

40% of people injured in 2006 were injured within the boundaries of Sydney South West and Sydney West Area Health Services;

Transfers from rural hospitals to trauma centres were most frequently recorded in the Hunter/New England Area Health Service (99 transfers), followed by transfers from the Greater Western Area Health Service (73 transfers);

Most assaults11 in the 2006 data occurred in Sydney South West Area Health Service districts;

Paediatric admissions fell in 2006, due largely to fewer admissions of children injured following low/medium falls and motor vehicle crashes;

Overall times to defi nitive care fi gures were maintained within NSW Health benchmarks. A key performance indicator - people injured in a metropolitan area in 2006 and transported directly to a trauma centre from the scene of their injury (within 2 hours) – achieved the NSW Health standard. The time to arrival at the defi nitive trauma hospital was an average 55 minutes for 87% of this group.

Executive Summary

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 7

Data Summary12

Total injured people and admissions The NSW Trauma Registry recorded 2,386 people injured with an ISS > 15 in 2006. Trauma centre admissions totalled

2,482 for this group of patients.

Table 1: Trauma Service (TS) Admissions and Deaths

Total Admissions/people people injured13 2482 admissions / 2386 people injured

Survived 2085 people 87.4% of all people injured

Died 301 people 12.6% of all people injured

Monthly Average 207 admissions

Minimum Monthly Admissions 181 August

Maximum Monthly Admissions 238 December

These fi gures rose slightly from those in 2005, and continue a series of small annual increases in trauma fi gures since the

establishment of the NSW Trauma Registry in 2002.

There may be several factors infl uencing this small but consistent growth in trauma fi gures, not least of which may be the

consolidation of trauma services and personnel in trauma centres where data is collected, as well as maturing practices in

capturing, managing and reporting trauma data in those centres.

Figure 1: People injured, 2002-2006 (including deaths)

The death rate within this group of patients14 in 2006 was 12.6%, which was down from the 2005 rate of 13.4%.

The NSW rate continues to be lower than the Australasian death rate for this population of 15%15.

Figure 1 also demonstrates that the volume of deaths in this population has remained reasonably steady since 2002.

The 2006 fi gure of 301 deaths is within the range for the fi ve year period (range from 257 to 309 deaths) and only 1

above the median (median number of deaths = 300).

12 All data is for calendar year 2006 (i.e. 01/01/2006 to 31/12/2006). 13 The term ‘people injured’ refers to distinct people, whereas numbers of ‘patients admitted to hospital’ may include a count of the same person one or more times, if that person is admitted to or transferred to additional trauma centres. 14 Death rates in this report are case fatality rates, calculated as follows: Case fatality rate = number of deaths divided by the number of patients in this data collection X 100 15 The National Trauma Registry Consortium (Australia and New Zealand). The National Trauma Registry (Australia and New Zealand) Report: 2003. 2006. Herston

TotalDiedPeople injured, 2002 – 2006 (including deaths)

Pe op

le In

jur ed

Mechanism of Injury

0

500

1000

1500

2000

2500

257 300 270 309 301

1781

2082

2263 2314 2389

2002 2003 2004 2005 2006

8 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

The fi gures in Table 2 confi rm that trauma is still predominantly a male health problem, with males outnumbering females

almost 3 to 1. The proportion of females in the data fell to 25.8%, similar to the 2004 rate. Outcome rates for each

gender however remained almost unchanged from 2005 (Table 3).

Table 2: Admissions by Gender

Female616 people (634 admissions) 25.8% of people and 25.5% of admissions

Male1770 people (1848 admissions) 74.2% of people and 74.5% of admissions

Table 3: Outcome by Gender

Gender Outcome – Survived Outcome - Died

Female 521 people (84.6% of Females) 95 people (15.4% of Females)

Male 1564 people (88.4% of Males) 206 people (11.6% of Males)

Trauma centre admissions Admissions of serious to critically injured patients to trauma centres are presented in Figure 2. The distribution of

admissions has remained largely unchanged since 2005, although paediatric admissions at Sydney Children Hospital and

The Children’s Hospital at Westmead fell slightly while all other trauma centre admissions increased.

Major trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital have been consistently greater than any

other single trauma centre during the past 5 years. This is largely due to the hospital being the only trauma centre in the

Hunter/New England Area Health Service (in contrast to other Area Health Services which host multiple trauma centres)16.

Figure 2: Admissions to trauma centres

16 The Area Health Service profi le (see following section) provides additional context for these trauma centre admission fi gures.

Data Summary

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Admissions to Trauma Centres – 2006

0

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100

150

200

250

300

350

400

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134 400 275 164 71 318 201 228 130 49 76 330 106

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 9

Area Health Services Data relating to Area Health Service distributions of people and admissions is included in this report for the fi rst time in

2006. The aggregation of data into Area Health Service groups is based upon postcodes collected for each record in the

NSW Trauma Registry, and upon the location of specifi c trauma centres within Area Health Services in NSW.

A patient may be injured within the boundaries of any of the nine Area Health Services in NSW. Trauma centres are only

located however in the following six Area Health Services:

J Hunter/New England

J Northern Sydney/Central Coast

J South Eastern Sydney/Illawarra

J Sydney South West

J Sydney West

J The Children’s Hospital at Westmead

Table 4 shows the distribution of admissions to trauma centres across Area Health Services. Numbers include admissions of

transferred patients, so that the same patient may be admitted to a trauma centre in different Area Health Services, or to

more than one trauma centre in the same Area Health Service.

Variation in admission numbers between the areas may be attributed in part to the location of specialist services, such

as the Spinal Injuries service at Prince of Wales and Royal North Shore Hospitals, paediatric services at Sydney Children’s

Hospital, and the burns service at Royal North Shore Hospital.

Table 4: Admissions by Area Health Service

Area Health Service Admissions %

Hunter/New England 402 admissions 16.2% of all admissions

Northern Sydney/Central Coast 453 admissions 18.3% of all admissions

South Eastern Sydney/Illawarra 584 admissions 23.5% of all admissions

Sydney South West 476 admissions 19.2% of all admissions

Sydney West 494 admissions 19.9% of all admissions

The Children’s Hospital at Westmead 76 admissions 3.1% of all admissions

Aggregation of the geographical location of injury into Area Health Service groups, based on the boundaries of each Area

Health Service, provides a snapshot of where traumatic injury occurred in NSW in 2006. People injured in Sydney South

West and Sydney West were the largest group, and accounted for almost 40% of people injured in 2006.

Signifi cantly fewer people were injured in non-metropolitan Area Health Services; however these numbers do not include

patients who may have been treated interstate. People injured in or treated in the ACT are also excluded from these

fi gures. Numbers may also refl ect the population densities of rural and metropolitan areas of the state.

Data Summary

10 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 5: Geographical Location of injury by Area Health Service (people injured)17

Area Health Service Admissions %

Greater Western 81 3.7% of all patients

Greater Southern 61 2.8% of all patients

Hunter/New England 383 17.5% of all patients

North Coast 51 2.3% of all patients

Northern Sydney/Central Coast 358 16.4% of all patients

South Eastern Sydney/Illawarra 387 17.7% of all patients

Sydney South West 439 20.1% of all patients

Sydney West 425 19.4% of all patients

Age distribution The age distribution of injured people in the 2006 data is similar to previous years. People aged from 15 to 44 years were

again the most represented in the data, accounting for 47.3% of all people injured. This was marginally lower than the

2005 fi gure of 47.8% and lower than the calculated rate for the entire 2002-2006 period, where the 15-44 years group

represented 49.8% of all people injured. The fi gure for this age group has in fact been falling gently since 2002, when it

was recorded at a fi ve year high of 52.9% of people injured.

Figure 3: Admissions to Trauma Services by age and gender

Table 6: Age - Top 3 Age Ranges

Age Range Count (people injured) % of people injured

15-24 458 19.2%

25-34 372 15.6%

35-44 301 12.6%

17 This table maps postcode of locality where injury occurred to Area Health Services. Numbers exclude records where the postcode of injury is unknown. In 2006 this

represented 200 records.

MaleFemaleAdmissions to Trauma Centres – 2002-2006 – Age and Gender

N um

be r o

f A dm

iss io

ns

Age Range

0

50

100

150

200

250

300

350

400

450

500

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

63 140 91 367 47 325 55 246 60 200 57 196 61 154 123 142 70 75 7 2

Data Summary

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 11

Mechanisms of injury

There was little change from 2005 to 2006 in the overall proportions of the main categories of injury: Road Trauma, Falls

and Assaults (see fi gure 3). Road trauma remained the leading mechanism of injury, associated with 44.2% of trauma,

followed by Falls (35.5%) and Assaults (10.2%).

Figure 4: Mechanisms of injury

Other 239

(10.1%)

Assault 244

(10.2%)

Falls 848

(35.5%)Road Trauma 1055

(44.2%)

Mechanisms of Injury

There were increases in the numbers of almost all mechanism of injury sub-categories consistent with the general increase

in people injured in 2006, expect for motor vehicle crashes and shootings, where the fi gures fell.

The most signifi cant increases were found in the Low/medium falls mechanism subcategory, up by 7.2% to 756 people

injured, and in the Pedal cycle mechanism subcategory, up 20.9% to 81 people injured. Other rises included Pedestrians

(up 7.8%) and Motorcycle crashes (up 5.2%).

Table 7: Mechanism of Injury - Road Trauma

Road Trauma Count % of Total Deaths (% of mechanism)

MVC 499 people 20.9% 53 people (10.6%)

MBC 241 people 10.1% 9 people (3.7%)

Pedestrian 234 people 9.8% 49 people (20.9%)

Pedal Cyclist 81 people 3.4% 1 person (1.2%)

Total Road Trauma 1055 people 44.2% 112 people (10.6%)

Death rates18 for Road Trauma and Falls were lower in 2006 than 2005 (10.6% and 15.4% respectively), although the

high rate for Pedestrians was worse than in 2006 (up to 20.9%), confi rming pedestrians as a vulnerable group in the

trauma population.

18 Includes 3 falls of unspecifi ed height

Data Summary

12 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 8: Mechanism of Injury - Falls

Road Trauma Count % of Total Deaths (% of mechanism)

Low/Medium Fall (<5m) 756 people 31.7% 119 people (15.7%)

High Fall (>5m) 89 people 3.7% 11 people (12.4%)

Total All Falls 848 people18 35.5% 131 people (15.4%)19

Small numbers of people have a greater affect on death rates calculated for categories of assault in the 2006 data. The

high rate of deaths for shootings should therefore be interpreted within the context of a relatively small group of patients

(<1% of the entire group of people injured in 2006). The overall death rate for assaults increased from 11.6% in 2005 to

13.1% in 2006. Table 9: Mechanism of Injury - Assaults

Assault Count % of Total Deaths (% of mechanism)

Blunt Assault 167 people 7% 10 people (6%)

Shooting 17 people <1% 9 people (52.9%)

Stabbing 60 people 2.5% 13 people (21.7%)

Total All Assaults 244 people 10.2% 32 people (13.1%)

Admission type Patients may be admitted to a trauma centre directly from the scene of injury, or following a transfer from another trauma

centre or a non-trauma hospital. In particular, patients requiring the services of a clinical super-specialty network such as

the NSW Acute Spinal Cord Injury Service (Adult), NSW Severe Burn Injury Service (Adult), or a paediatric trauma service

may be transferred.

NSW ITIM also monitors rates and patterns of interhospital patient transfers in the NSW Trauma system, to ascertain the

effectiveness of the Ambulance Service of NSW (ASNSW) Protocol 4 early notifi cation and bypass system, and tertiary

referral networks20 in NSW.

At 74.3%, the rate of ‘direct from scene’ admissions21 to trauma centres remained virtually unchanged from 2005 to

2006. The remainder of patients in the data admitted to a trauma centre were transferred from either another trauma

centre or another non-trauma hospital. Table 10: Admission Type

Admission Type Count % of Total

Transfer In 639 admissions 25.7% of all admissions

Direct From Scene 1843 admissions 74.3% of all admissions

Table 11: Outcome by Admission Type

Admission Type Outcome – Survived Outcome - Died

Transfer In 579 admissions (90.6%) 60 admissions (8.4%)

Direct From Scene 1602 admissions (86.9%) 241 admissions (13.1%)

18 Includes 3 falls of unspecifi ed height 19 Includes 1 death from a fall of unspecifi ed height 20 I See NSW Health Policy Directive - Critical Care Adult Tertiary Referral Networks 2006 (Doc No. PD2006_046), which defi nes links between Area Health Services and tertiary referral hospitals. The policy also defi nes clinical super-specialty referral networks including the NSW Severe Burn Injury Service (Adult), NSW Acute Spinal Cord Injury Referrals (Adult), and NSW Major Trauma Referrals (Adult). 21 Where the patient was transported directly from the place where injury was sustained to a trauma centre

Data Summary

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 13

Intensive care

Due to the severity of their injuries, patients in this data collection are often admitted to an intensive care unit at a

trauma centre. An intensive care unit (ICU) is a designated ward of a hospital which is specially staffed and equipped to

provide observation, care and treatment to patients with critical injuries. The ICU provides special expertise and facilities

for the support of vital functions and utilises the skills of medical, nursing and other staff trained and experienced in the

management of these problems.22

In 2006 42.7% of injured people (1,018 people) recorded in the NSW Trauma Registry were admitted to an ICU.

This fi gure was almost unchanged from 2005 (1,026 people or 42.5% of injured people).

The death rate for this group was 14%, contrasting with the death rate of 10.8% for people not admitted to an intensive

care unit (Table 11). In general this refl ects a higher severity of injury for patients requiring intensive care unit admission.

The average length of stay in an ICU in 2006 was 7.53 days (Table 12). The length of stay in an ICU varied with

outcome – patients who survived stayed in ICU an average 7.84 days, while patients who died stayed an average 5.62

days in an ICU (Table 13)23.

Table 12: ICU Admissions

Admission to ICU Count % of Total

Yes 1018 people/ 1030 ICU admissions

42.7% of people/ 41.5% of hospital admissions24

No 1368 people/ 1452 hospital admissions

57.3% of people/ 58.5% of hospital admissions

Table 13: ICU Admission by Outcome

Admission to ICU Outcome – Survived Outcome - Died

Yes 886 admissions (86%) 144 admissions (14%)

No 1295 admissions (89.2%) 157 admissions (10.8%)

Table 14: ICU Average Length of Stay (LOS)

Outcome - All Outcome – Survived Outcome - Died

7.53 Days 7.84 days 5.62 days

22 National Health Data Committee 2003. National Health Data Dictionary. Version 12, Volume 1, AIHW cat. No. HWI 43. Canberra: Australian Institute of Health and

Welfare 23 Outcome is recorded for the entire period of acute care admission. Patients who died and who were admitted to an ICU may not necessarily have died in an ICU.

24 The lower percentage of hospital admissions admitted to ICU (compared to the percentage of people injured admitted to an ICU) is due to the effect of transferred

patients who were admitted in the defi nitive care trauma hospital but not admitted in the fi rst trauma centre. This is not unusual for patients transferred soon after

arrival at a trauma centre

Data Summary

14 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Hospital length of stay The average overall hospital length of stay (for the period of acute care admission) for 2006 was 15.69 days, slightly lower

than the 2005 average of 15.86 days25. The average hospital length of stay for patients admitted directly to a trauma

centre form the scene of their injury was also lower than the 2005 average (down from 15.4 days to 14.88 days).

Table 15: Hospital Average Length of Stay (LOS)

LOS Outcome – All Outcome – Survived Outcome - Died

Overall LOS 15.69 days 17.31 days 4.42 days

Direct Admission LOS26 14.88 days 16.63 days 3.77 days

Transfer in Admission LOS 18.03 days 19.19 days 7.1 days

Arrival mode

Arrival modes recorded in the NSW Trauma Minimum Data Set refer to the way in which a patient is delivered to an

admitting trauma centre. For patients transferred to a trauma centre, arrival modes describe the manner in which they

were transferred. Arrival modes include:

J Ambulance

J Fixed Wing27

J Helicopter

J NETS28

J Private Vehicle

J Other29

Arrival modes recorded in the NSW Trauma Minimum Data Set are only recorded for admissions to trauma centres in NSW.

In 2006, the proportion of ambulance arrivals30 at trauma centres fell from 71% in 2005 to 67.4%. The other main arrival

modes, Helicopter and private vehicle arrivals, remained almost unchanged from 2005.

Table 16: Arrival Mode - Top 3 Arrival Modes

Arrival Mode Admissions % of Total

Ambulance 1674 admissions 67.4%

Helicopter 410 admissions 16.5%

Private Vehicle 161 admissions 6.5%

25 The hospital length of stay recorded in the NSW Trauma Minimum Data Set is the length of stay in a trauma centre while classifi ed as an acute care patient.

Additional days in hospital, for example while attending rehabilitation, are not included in these fi gures. For patients admitted to more than one trauma centre,

lengths of stay in each centre are counted separately.

26 In this table, admissions are either ‘Direct’ (from scene), where a patient is admitted directly from the scene of the injury, or ‘Transferred in’ to a defi nitive trauma

hospital from another hospital.

27 For fi xed wing arrival modes, the data represents the primary mode of transport used to deliver the patient to an admitting trauma centre.

28 NETS = NSW Newborn & Paediatric Emergency Transport Service. ‘NETS’ is the emergency service for medical retrieval of critically ill newborns, infants and children

in NSW. NETS does not transport from the scene (pre-hospital), but assists with transport for patients too sick for care to continue in their current hospital (source:

http://www.nets.org.au)

29 Other modes of arrival may include taxis, buses, bicycles etc, as well as patients arriving on foot.

30 Arrival modes recorded in the NSW Trauma Minimum Data Set refer to the manner in which a patient is delivered to the admitting trauma centre. For patients

transferred to a trauma centre, arrival modes also describe the manner in which they were transferred.

Data Summary

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 15

Surgical procedures

The following surgical procedures are recorded in the Trauma Minimum Data Set, if the procedure was performed within

24 hours of admission to a trauma centre:

J Craniotomy - a surgical operation in which part of the skull, called a skull fl ap, is removed in order to access the brain;

J Laparotomy - a surgical incision into the abdominal cavity to examine the abdominal organs and aid diagnosis;

J Open (compound) fractures (called Open Ext# in the Trauma Minimum Data Set) involve wounds that communicate

with the fracture and may expose bone to contamination; and

J Thoracotomy - a surgical incision into the chest. It is performed by a surgeon to gain access to the thoracic organs,

most commonly the heart, the lungs, the oesophagus or thoracic aorta31

Other surgical procedures not listed above are listed as ‘Other’ in the Trauma Minimum Data Set.

32.1% of all patients (765 people) underwent surgery (901 procedures) within 24 hours of admission to a trauma centre

in 2006, up slightly from the 2005 fi gure of 31%. Craniotomy continued to be the most common surgical procedure,

performed on 224 patients in 2006, which concurs with the head and neck ISS body region being the most commonly

injured ISS body region in the 2006 data set.

Table 17: Operating Suite in First 24 Hours - Top 3 Procedures

Operating Suite Procedure Count % of Total Procedures

Craniotomy 224 procedures 24.9%

Laparotomy 146 procedures 16.2%

Open Ext# 144 procedures 16%

31 Defi nitions of these surgical procedures obtained from http://www.wkipedia.com/

Data Summary

16 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Times and Days of Week

As Figure 5 demonstrates, early to late afternoon continued to be the most common time of day for serious to critical

trauma in 2006, with 34.5% of people injured between the hours of 12 noon and 6pm. The greatest numbers of people

were injured between 4pm and 5pm (166 people). A second smaller peak occurred between 10pm and 3am, when

approximately 16% of people were injured.

Figure 5: People injured by hour of day when injury occurred

People injured by hour of day

P eo

pl e

in ju

re d

Hour (24 hr)

0

20

40

60

80

100

120

140

160

180

88

69 75

42 38

46

71 75

63

79

95

123 131 132 129

147

166

118 114

107

80

52

82

69

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

Table 18: Injury Time - Top 3 Hours of the Day Injury Occurred (excludes patients where time of injury is unknown)

Hour of Day Count (People Injured) % of Total

16:00 166 7.6%

15:00 147 6.7%

13:00 132 6 %

The greatest numbers of patients were admitted to a trauma centre between 4pm and 6pm (304 admissions).

Table 19: Admission Time - Top 3 Hours of the Day of Admission to Defi nitive Trauma Hospital32

Hour of Day Count (Admissions) % of Total

17:00 162 7%

14:00 144 6.3%

16:00 142 6.1%

The most common days for traumatic injuries in 2006 were Saturday, Sunday and Monday, with Saturday the busiest day

of the week (458 patients). In total, 1195 people were injured on these three days, or 50.1% of all people injured in 2006.

Data Summary

32 The defi nitive trauma hospital is considered to be the trauma centre where a patient is provided with all treatment and care required for their injuries.

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 17

Table 20: Injury Day of Week

Day of Week Count (People injured) % of Total

Saturday 458 patients 19.2%

Sunday 420 Patients 17.6%

Monday 317 patients 13.3%

Wednesday 301 patients 12.6%

Thursday 300 patients 12.6%

Friday 299 patients 12.5%

Tuesday 287 patients 12%

Injury Severity Score and body regions

There was little variation in the distribution of Injury Severity Scores (ISS) in 2006 from previous years, with 56.3% of

patients recording an ISS in the 16-24 range (serious injuries), 36% recording an ISS in the 25-40 range (severe injuries)

and 7.6% recording an ISS in the 41-75 range (critical injuries).

Table 21: Injury Severity Score (ISS)

ISS Range Count (People Injured) % of Total

16-24 1344 patients 56.3%

25-40 860 patients 36%

41-75 182 patients 7.6%

In 2006 the head and neck body region continued to be the most frequently recorded injury region in the NSW Trauma

Registry, followed by the chest body region and extremities body region33. Head injuries have been recognised as a

signifi cant issue in trauma, and guidelines are currently being developed to assist in management of head injuries, due

for release in June 2007.

The head and neck body region was recorded for 72.2% of injured people in 2006, up from the 2005 fi gure of 70.6%.

The chest was recorded for 41.5%, and the extremities body region recorded for 37.2% of injured people in 2006.

33 While the body region provides an indication of the location of injuries for each patient, it does not necessarily indicate the nature of the injury. The Head or Neck

ISS Region for example may include cervical spine injuries as well as traumatic brain injuries and skull fractures.

Data Summary

18 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 6: AIS body regions

AIS body regions

% o

f P eo

pl e

0

10

20

30

40

50

60

70

80

90

100

ExternalExtremityAbdomenChestFaceHead

72.21

17.14

41.45

21.54

37.22 31.98

Times to Defi nitive Care

Times to defi nitive care for patients with an ISS > 15 admitted to a trauma centre provide an indicator of the effectiveness

of the NSW trauma system, encompassing the progress of the patient from the scene of injury to admission to their

defi nitive trauma hospital.

Times to defi nitive care34 are calculated individually for each patient and grouped into time periods. The numbers are

further divided into rural and metropolitan locations of injury35, and into groups of patients transported directly to a

defi nitive trauma hospital from the scene of their injury, and those transferred to a defi nitive trauma hospital from another

hospital.

For people injured in a metropolitan area in 2006, the time to arrival at the defi nitive trauma hospital was an average 55

minutes for 87% of those who were transported directly to a trauma centre from the scene of injury.

Table 22: Time to defi nitive care for patients admitted directly to a defi nitive trauma hospital, rural vs metropolitan location of injury

Time period Rural (n=115) Metropolitan (n=1375)

0-2 hours 63 patients (54.8%) Average 1 hour 28 minutes

1200 patients (87%) Average 55 minutes

2-6 hours 40 patients (34.8%) Average 2 hours 45 minutes

82 patients (6%) Average 3 hours 11 minutes

6-12 hours 6 patients (5.2%) Average 8 hours 34 minutes

23 patients (1.7%) Average 8 hours 29 minutes

12-24 hours 2 patients (1.7%) Average 13 hours 28 minutes

25 patients (1.8%) Average 16 hours 25 minutes

Greater than 24 hours 4 patients (3.5%) Average 173 hours 15 minutes

45 patients (3.3%) Average 89 hours 34 minutes

34 The time taken to defi nitive care is a value calculated from the date and time of injury to the date and time of admission to the trauma centre where defi nitive care was provided to the patient. These fi gures exclude records where time of injury is unknown. 35 This grouping is performed using the postcode where injury occurred. Metropolitan locations include Greater Metropolitan Sydney, extending from Newcastle City in the North to Wollongong in the South.

Data Summary

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 19

Table 23: Time to defi nitive care for patients transferred to a defi nitive trauma hospital, rural vs metropolitan location of injury36

Time period Rural (n=236) Metropolitan (n=277)

0-2 hours 5 patients (2.1%) Average 1 hour 13

minutes

14 patients (5%) Average 1 hour 9

minutes

2-6 hours 44 patients (18.6%) Average 4 hours

24 minutes

70 patients (25.3%) Average 4 hours

25 minutes

6-12 hours 94 patients (39.8%) Average 8 hours

45 minutes

96 patients (34.7%) Average 8 hours

28 minutes

12-24 hours 51 patients (21.6%) Average 15 hours

18 minutes

39 patients (14.1%) Average 17 hours

17 minutes

Greater than 24 hours 42 patients (17.8%) Average 83 hours

57 minutes

58 patients (20.9%) Average 77 hours

55 minutes

Data Summary

36 Figures in this table represent patients transferred to a defi nitive trauma hospital from another hospital, including patients transferred from non-trauma hospitals to trauma centres, and patients who may have been transferred between trauma centres for defi nitive care.

20 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Focus on low/medium falls (<5m) Who are they? Typically males, aged 65 - 84 years

When were they injured? The most frequent day was Saturday, most frequent time – from early to late afternoon

Where were they injured? Most were injured in Northern Sydney/Central Coast Area Health Service districts

What were the top 3 injuries? Head and neck (90.9% of patients) External (37%) Chest (20.6%)

Trauma system response 77.9% of patients who were admitted directly from the scene of injury arrived within 2 hours

Case fatality rate 15.7%

General

Low/medium falls are the most frequently recorded mechanism of injury in the NSW Trauma Registry. In 2006 they

represented 31.7% of all cases in the Registry, a total of 756 people injured. This fi gure was an increase on the 2005

fi gure of 718 people injured. Indeed, as Figure 5 demonstrates, there has been a steady rise in the volume of serious to

critical injuries following low/medium falls in the past 5 years, highlighting the need to more fully understand the nature

of these injuries (fi gure 7).

Also of concern is the case fatality rate, or death rate in this group of patients. The death rate in 2006 was 15.7%,

exceeding the overall death rate in the 2006 data (12.6%). In addition, the death rate for people aged 65 years and older

was higher still, rising to 29.7% in the 85-94 years age group.

Figure 7: Low/medium falls, 2002-2006

Low/medium falls – 2002-2006

P eo

pl e

in ju

re d

Year

0

100

200

300

400

500

600

700

800

459

2002 2003 2004 2005 2006

587

678 718

756

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 21

Characteristics of the injured population

In contrast to many other mechanisms of injury recorded in the NSW Trauma Registry, low/medium falls (<5m) are

predominantly a problem for the older population. This single mechanism of injury was recorded for 70.4% of all people

aged 65 years and over.

Figure 8: Low to medium fall (<5m) admissions to all Trauma Centres by age

Low to medium fall (<5m) admissions to all Trauma Centres by age

N um

be r

of A

dm is

si on

s

Age Range

0

20

40

60

80

100

120

140

160

180

200

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

37 37 36 43

69

97

126

184

118

9

The pattern of time of injury was similar to the general time of injury pattern for all cases in 2006. Low/medium

falls (<5m) in 2006 were most common between midday and 2pm (95 admissions) and between 4pm and 5pm (48

admissions).

Figure 9: Low to medium fall (<5m) trauma by hour of day that injury occurred

Low to medium fall (<5m) trauma by hour of day that injury occurred

P eo

pl e

in ju

re d

Hour (24 hr)

0

10

20

30

40

50

60

11

20

9 12

16 18

23

19

33 36

46 49

44 42

48

37 39

37

27 27

8

21

16 19

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

Like the general pattern for day of injury in 2006, Saturday, Sunday and Monday were the most common days for low/

medium falls. As in 2005 the busiest day of the week recorded for low/medium falls was Saturday, with 133 admissions.

Low/Medium Falls

22 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 10: Low to medium fall (<5m) admissions by day of week that injury occurred

Low to medium fall (<5m) admissions by day of week that injury occurred

A dm

is si

on s

0

20

40

60

80

100

120

140

SundaySaturdayFridayThursdayWednesdayTuesdayMonday

126

105 109

104

83

133

121

Over 50% of night-time injuries (between 11pm and 4am) resulting from low/medium falls were recorded by the group

aged 65 years and older (fi gure 10). The two afternoon peaks were also more distinct in this age group, from midday to

2pm, and from 4pm until 7pm.

Figure 11: Low/medium falls (<5m) by hour of day of injury for people aged 65 years and over

Low/medium falls (<5m) by hour of day of injury for people aged 65 years and over

P eo

pl e

in ju

re d

Hour (24 hr)

0

5

10

15

20

25

30

3

14

3

9 8

11

16

11

23 22

28 28

24

20

25 25

28

25

10

8

3

11

7

9

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

A different pattern also emerges for the day of the week of injury for people aged over 65 years. Here, instead of

weekends we fi nd the days from Monday to Thursday most frequently recorded for low/medium falls in this age group,

with Monday the most frequent (68 people injured).

Low/Medium Falls

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 23

Figure 12: Low/medium falls (<5m) by day of week for people aged 65 years and older

Low to medium fall (<5m) by day of week for people aged 65 years and older

P eo

pl e

in ju

re d

0

10

20

30

40

50

60

70

80

SundaySaturdayFridayThursdayWednesdayTuesdayMonday

68 64

60

55

37

55

41

Low/medium falls were most common in the Northern Sydney/Central Coast Area Health Service in 2006. 149 people

sustained their injuries due to low/medium falls within this area health service. Although slightly lower than the 2005

fi gure of 166 people injured, the incidence of low/medium falls in this area health service has grown by almost 50% since

2002 (from 100 injured people).

Figure 13: Low/medium falls (<5m) - geographical location of injury by Area Health Service

Low/medium falls (<5m) – geographical location of injury by Area Health Service

P eo

pl e

in ju

re d

0

20

40

60

80

100

120

140

160

Sydney WestSydney South West

South Eastern Sydney / Illawara

Northern Sydney Central Coast

North CoastHunter New England

Greater WesternGreater Southern

11 16 17

136

149

115

124 122

Low/medium falls commonly occur in the home. Overall, 58.6% of all low/medium falls occurred at home, and the

frequency of falls in the group aged 0-14 years and several older age groups was even higher.

Low/Medium Falls

24 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 14: Low to medium fall (<5m) trauma patient admissions to all Trauma Services by age (injured at home)

Low to medium fall (<5m) trauma patient admissions to all Trauma Services by age (injured at home)

% in

ju re

d at

h om

e

Age Range

0

10

20

30

40

50

60

70

80

90

100

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

71.43

32.43

27.03

38.10

49.25

69.89

58.14

67.03 64.41

44.44

Many of the trauma services and other health professionals are involved in regular community falls prevention and

education activities to reduce the incidence of falls-related injury.

Injury Characteristics

Only 1.2% of low/medium fall related injuries in 2006 were in the ISS 41-75 (critical injury) range, lower than the 2006

average 7.6% for this ISS range.

Figure 15: Low/medium fall (<5m) related admissions to trauma centres by ISS range

41-75 1.19%

16-24 59.26%

25-40 39.55%

Low/medium fall (<5m) related admission to trauma centres by ISS Range

The head and neck body region features prominently in the NSW Trauma Registry for low/medium falls, and in 2006 was

recorded as a location of injury in 90.9% of cases. This greatly exceeds the average frequency of the head and neck body

region across all mechanisms of injury in 2006 of 72.2%.

Low/Medium Falls

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 25

Figure 16: AIS body regions for low/medium falls (<5m)

AIS body regions for low/medium falls (<5m)

% o

f P at

ie nt

s

0

10

20

30

40

50

60

70

80

90

100

ExternalExtremityAbdomenChestFaceHead

90.87

14.15

20.63

8.73

19.31

37.04

The external body region also features more prominently in low/medium falls than in the general fi gures, recorded in 37%

of cases in 2006 (compared with 32% overall), and appearing as the second most frequently recorded body region for

low/medium falls.

Trauma system response

There are several characteristics of the trauma system’s response to low/medium falls that may be observed in the NSW

Trauma Registry:

J A higher than average proportion of people arrive at trauma centres using private vehicles;

J Proportionally fewer injured people arrive at trauma centres directly from the scene of their injury; and

J Of those who do arrive at a trauma centre directly from the scene of their injury, proportionally fewer people arrive

within the fi rst two hours after sustaining their injury.

Perhaps consistent with the higher incidence of injuries occurring at home, the rate of arrivals at hospital using private

vehicles is higher than the overall 2006 average (11.4%, contrasting with the overall 2006 average of 6.5%). The rate of

ambulance arrivals is also higher, at 77.2% than the overall 2006 average (67.4%) perhaps refl ecting the higher rate of

interhospital transfers (using ambulances) to defi nitive care hospitals.

Low/Medium Falls

26 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 17: Low/medium falls - mode of arrival

Low/medium falls – mode of arrival

P eo

pl e

in ju

re d

Mode of Transport

0

100

200

300

400

500

600

583

Ambulance Fixed Wing Helicopter Nets Private Vehicle

23 55

8

86

The proportion of people transported directly from the scene of low/medium falls related injuries to a trauma centre in

2006 was 67.5%, almost identical to the 2005 rate of 67.8%. This rate is lower than the overall rate of direct from scene

admissions (74.3%).

The lower proportion of direct from scene admissions demonstrates the complexity of triage for this cohort of patients.

This has been identifi ed as an issue for consideration in pre-hospital trauma bypass protocols and the in-hospital trauma

team activation criteria.

Figure 18: Low/medium fall (<5m) related admissions to trauma centres by admission type

Direct from scene 528

(67.5%)

Transfer in 254

(32.5%)

Low/medium fall (<5m) related admission to trauma centres by admission type

The proportion of people transported directly to a defi nitive trauma care hospital within 2 hours was also lower than many

other mechanisms of injury groups. Only 73.8% of the low/medium falls group were transported directly to a defi nitive

trauma hospital from the scene of fall in 2006 within 2 hours of the time of injury. In contrast, 85.1% of people injured

in motor vehicle crashes, 85.9% of people injured in motorcycle crashes, and 96.8% of pedestrians injured who were

transported directly to a defi nitive care hospital arrived within 2 hours of their injury (fi gure 18).

Low/Medium Falls

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 27

Figure 19: Times to defi nitive care, direct from scene, within 2 hours, Low/medium falls, MVC, MBC, Pedestrian

Times to definitive care, direct from scene, within 2 hours, Low/medium falls, MVA, MBA, Pedestrian

% w

ith in

2 h

ou rs

0

10

20

30

40

50

60

70

80

90

100

73.8

Low/medium falls

MVC MBC Pedestrian

85.1 85.9

96.8

Craniotomies were the most frequently recorded surgical procedure, consistent with the AIS Head and Neck region as the

most commonly recorded body region injured.

Figure 20: Low/medium falls (<5m) - surgical procedures

Low/medium falls (<5m) – surgical procedures

N um

be r

of p

ro ce

du re

s

Procedure

0

20

40

60

80

100

120

98

Craniotomy Laparotomy Open Ext Thoracotomy Other

9 112

45

30.4% of people injured by low/medium falls were admitted to an intensive care unit, a much lower rated than the overall

ICU admission rate of 42.7%. This may refl ect a lower ISS in the critical (41-75) range (see fi gure 14).

Low/Medium Falls

28 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 21: Low/medium falls (<5m) - Intensive Care Unit admissions

Not admitted 544

(69.6%)

Admitted to ICU

238 (30.4%)

Low/medium falls (<5m) – ICU admissions

Outcomes - Case fatality

The case fatality rate, or death rate in the low/medium falls group of patient for 2006 was 15.7%. This is higher than the

overall death rate in the 2006 data of 12.6%.

The death rate for people aged 65 years and older in the low/medium falls group was higher still at 20.1%, and the rate

rose as high as 29.7% in the 85-94 years age group. Death rates in the older age groups are however affected by

co-morbidities and are not necessarily attributable to traumatic injuries alone.

Figure 22: Low/medium fall related admissions to trauma centres by age and outcome

Low/medium fall related admissions to all trauma centres by age and outcome

N um

be r

of A

dm is

si on

s

Age Range

0

20

40

60

80

100

120

140

160

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

SurvivedDied

0 4 3 4 8 12 16 35 35 2

37 33 33

39

61

85

110

149

83

7

Low/Medium Falls

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 29

Focus on Pedestrians

Who are they? Typically males, aged 0 - 25 years

When were they injured? The top days were Wednesdays, Saturdays, from mid to late afternoon

Where were they injured? Most were injured in South Eastern Sydney/Illawarra Area Health Service districts

What were the top 3 injuries? Head and neck (82% of patients), Extremities (66.7%) Chest (50.4%)

Trauma system response 96.8% of patients who were admitted directly from the scene of injury arrived

within 2 hours

Case fatality rate 20.9%

General

Pedestrians represent a small but growing number of people in the NSW Trauma Registry, representing in 2006 almost

10% of all people with serious to critical injuries. In 2006 there were 235 pedestrians injured and admitted to a trauma

centre, higher than the 2005 fi gure of 220 injured pedestrians (fi gure 21).

Figure 23: Pedestrian trauma, 2002-2006

Pedestrian trauma – 2002-2006

P eo

pl e

in ju

re d

Year

0

25

50

75

100

125

150

175

200

225

250

181

2002 2003 2004 2005 2006

205

219 220

235

30 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Characteristics of the injured population

The age distribution pattern for pedestrian trauma is very different to that of low/medium falls (see fi gure 2 above).

The fi gures are skewed to younger age groups, in particular to those aged 15-24 years, which represented 16.7% of all

pedestrian injuries in 2006.

Figure 24: Pedestrian trauma patient admissions to all Trauma Centres by age and gender

Pedestrian trauma patient admissions to all Trauma Centres by age range

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

35

40

45

50

85-9475-8465-7455-6445-5435-4425-3415-240-14

32

39

30

24 24 25 25 23

12

The distribution of pedestrian injuries by hour of day that injury occurred varies from the overall distribution for 2006

(see fi gure 4). Most noticeable is a drop in pedestrian injuries during early to mid afternoon (from 1pm until 3pm),

and a dramatic absence of pedestrian injuries between 11 am and midday. Both of these variations are consistent with

pedestrian injuries from 2005.

Figure 25: Pedestrian trauma by hour of day that injury occurred

Pedestrian trauma by hour of day that injury occured

P eo

pl e

in ju

re d

Hour (24 hr)

0

5

10

15

20

25

4

7

2

4 3

7 7

9

14

2

16

6

10

14

16

21

17 16

14

11

6 7

5

10

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

The busiest day of the week for pedestrian injuries was again Saturday, resulting in 42 admissions to trauma centres

in 2006. This fi gure was almost identical to the 2005 number of 41 admissions. The busiest weekday in 2006 was

Wednesday, with 40 admissions.

Pedestrians

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 31

Figure 26: Pedestrian trauma admissions by day of week that injury occurred

Pedestrian trauma admissions by day of week that injury occurred

N um

be r

of A

dm is

si on

s

Day of Week

0

5

10

15

20

25

30

35

40

45

50

SundaySaturdayFridayThursdayWednesdayTuesdayMonday

33 32

40

34

37

42

26

The majority of pedestrian injuries occurred in the South Eastern Sydney/Illawarra Area Health Service districts in 2006.

This area health service area included the Inner Sydney statistical local area where the greatest number of pedestrian

injuries occurred during the year, 15 people injured in total.

In other areas, Marrickville statistical local area (in the Sydney South West Area Health Service district) recorded 11

pedestrian injuries, the second highest number for a statistical local area in 2006.

Figure 27: Pedestrians - geographical location of injury by Area Health Service

Pedestrians – geographical location of injury by Area Health Service

P eo

pl e

in ju

re d

Sydney WestSydney South West

South Eastern Sydney / Illawara

Northern Sydney Central Coast

North CoastHunter New England

Greater WesternGreater Southern 0

5

10

15

20

25

30

35

40

45

50

55

60

9

4 3

56

43

26

46

33

Pedestrians

32 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Injury Characteristics

19% of pedestrian related injuries in 2006 were in the ISS 41-75 (critical injuries) range, signifi cantly higher than the

overall fi gure of 7.6% for this ISS range across all mechanisms of injury for 2006. This highlights the seriousness of

pedestrian related injuries.

Figure 28: Pedestrian related admissions to trauma centres by ISS range

Pedestrian related admission to trauma centres by ISS Range

16-24 105 45%

25-40 84

36%

41-75 45

19%

The head and neck body region was recorded as the location of injury in 82% of pedestrian injuries in 2006, while the

Extremities body region was recorded as location of injury for 66.7% of pedestrian injuries.

Figure 29: AIS body regions for pedestrian trauma

AIS body regions for pedestrian trauma

% o

f P eo

pl e

0

10

20

30

40

50

60

70

80

90

100

ExternalExtremityAbdomenChestFaceHead

82.05

24.79

50.43

29.49

66.67

27.35

Pedestrians

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 33

Trauma system response

The following observations may be made regarding the trauma system response to pedestrian injuries in 2006:

J A higher than average proportion of people arrived at trauma centres in an ambulance;

J A higher than average proportion of people arrived at trauma centres directly from the scene of their injury; and

J Of those who arrive at a trauma centre directly from the scene of their injury, a very high proportion arrives within 2

hours of sustaining their injury.

Ambulance was the mode of arrival for 81.4% of injured pedestrians, higher than the overall 2006 average (67.4%), but

a little lower than the 2005 fi gure of 84.7%. Helicopters were recorded for 10.6% of pedestrians, lower than the 2006

average (16.5%), but higher than the 2005 fi gure of 4.2%, suggesting increased use of helicopters to retrieve injured

pedestrians in 2006.

Figure 30: Pedestrian trauma - mode of arrival

Pedestrian trauma – mode of arrival

P eo

pl e

in ju

re d

Mode of Transport

0

20

40

60

80

100

120

140

160

180

200

192

Ambulance Fixed Wing Helicopter Nets Private Vehicle

7

25

93

The proportion of people who arrived at a trauma centre directly from the scene of their injury was 84.4%, higher than

the overall 2006 average of 74.3%, and almost identical to the 5 year average for pedestrian injuries of 83.4% (for direct

from scene admissions).

Pedestrians

34 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 31: Pedestrian related admissions to trauma centres for 2006 by admission type

Direct from scene 206

(84.4%)

Transfer in 38

(15.6%)

Pedestrian related admissions to trauma centres for 2006 by admission type

The proportion of people transported directly to a defi nitive trauma care hospital within 2 hours after sustaining their

injury was one of the highest recorded in the NSW Trauma Registry in 2006. 96.8% of injured pedestrians admitted

directly from the scene of their in jury arrived within 2 hours, which was higher than both metropolitan and rural direct

from scene admissions, and better than many other mechanisms of injury (see fi gure 18).

Figure 32: Pedestrian trauma - surgical procedures

Pedestrian trauma – surgical procedures

N um

be r

of p

ro ce

du re

s

Procedure

0

5

10

15

20

25

30

35

40

45

50

55

60

23

Craniotomy Laparotomy Open Ext Thoracotomy Other

14

24

4

49

Excluding the non-specifi c category of ‘other’, surgical procedures for open (compound) fractures were the most common

procedure recorded for injured pedestrians in 2006 (24 procedures). Next most common were craniotomies with 23

procedures.

Pedestrians

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 35

Figure 33: Pedestrian trauma - intensive care admissions

Not admitted 112

(47.86%) Admittedto ICU 122

(52.14%)

Pedestrian trauma – ICU admissions

52.1% of injured pedestrians were admitted to an intensive care unit in 2006. This is higher than the overall ICU

admission rate for 2006 of 42.7, and probably refl ects the higher proportion of injuries in the ISS 41-75 (critical injuries)

range for this group of patients.

Outcomes - Case fatality

The case fatality rate or death rate for injured pedestrians in the NSW Trauma Registry is 20.9%, much higher than the

overall 2006 death rate of 12.6%. The death rate is highest in the group of people aged 85-94 (33.3%), and lowest in the

group aged 45-54 years (12.5%).

The high death rate in this group is likely to be a result of the increased severity of injuries for these patients, particularly

as the trauma system response appears to be very positive for this group (ie, higher proportion of direct from scene

admissions, more people arriving within 2 hours, more ICU admissions).

Figure 34: Pedestrian trauma by age and outcome

Pedestrian trauma by age and outcome

N um

be r

of A

dm is

si on

s

Age Range

SurvivedDied

0

5

10

15

20

25

30

35

40

45

50

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

7

25

5

34

7

23

6

18

3

21

4

21

7

18

6

17

4

8

Pedestrians

36 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Individual Trauma Service Summaries Gosford Hospital

Table 24: Admissions and Deaths, Gosford Hospital

Total Admissions 134

Survived 113 84.3% of total

Died 21 15.7% of total

Direct Admission 134 100% of total

Transfer In Admission 0 0% of total

Monthly Average 11

Table 25: Admissions by gender, Gosford Hospital

Gender Count % of Total

Female 37 27.6%

Male 97 72.4%

Figure 35: Trauma admissions to Gosford Hospital by age and gender

MaleFemaleTrauma Admissions to Gosford Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

35

40

45

50

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

3

9 7

19

2

14

2

7

4

10

4

11

1

10 8 9

5

8

1 0

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 37

Figure 36: Trauma admissions to Gosford Hospital by age range and outcome (%)

Trauma admissions to Gosford Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100

3 5 0 1 1 0 2 5 4 0

9 21 16 8 13 15 9 12 9 1

Figure 37: Trauma admissions to Gosford Hospital by Injury Severity Score and outcome

Trauma admissions to Gosford Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75 0

10

20

30

40

50

60

70

80

90

100

Survived

Died

4 13 4

72 37 4

Individual Trauma Service Summaries Gosford Hospital

38 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 26: Trauma admissions to Gosford Hospital by mechanism of injury

Mechanism % of Total

Assault 7.5%

Burns 2.2%

Fall < 1m 20.15%

Fall > 5m 3.7%

Fall 1-5m 9.7%

Horse <1%

Industrial <1%

MBC Rider 6.7%

MVC Back Pass 2.2%

MVC Driver 12.7%

MVC Front Pass 4.5%

Other 7.5%

Pedal Cyclist 1.5%

Pedestrian 11.9%

Recreation 3.7%

Sport <1%

Stabbing 3.7%

Figure 38: Trauma admissions to Gosford Hospital by mechanism and outcome (%)37

SurvivedDiedTrauma admissions to Gosford Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 15

0

4

1

33

7

9

0

21

5

2

0

11

5

18

3

37 Patients transferred to another hospital are counted as survived of these surgical procedures obtained from http://www.wkipedia.com/

Individual Trauma Service Summaries Gosford Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 39

Table 27: Trauma admissions to Gosford Hospital by Arrival Mode

Arrival Mode % of Total

Ambulance 87.3%

Helicopter 3%

Private Vehicle 9%

Other <1%

Table 28: Trauma admissions at Gosford Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 35 26.1%

No 99 73.9%

Table 29: ICU Average Length of Stay (LOS) at Gosford Hospital

Outcome – All Outcome – Survived Outcome - Died

7.03 days 6 days 18 days

Table 30: Hospital Average Length of Stay at Gosford Hospital

Outcome – All Outcome – Survived Outcome - Died

4.81 days 5.06 days 3.43 days

Table 31: Transfer In Admissions to Gosford Hospital by Area Health Service

Transferring Area Health Service % of Transfers

No patients with an ISS > 15 were transferred for admissions to Gosford Hospital in 2006

Individual Trauma Service Summaries Gosford Hospital

40 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

John Hunter Hospital / John Hunter Children’s Hospital Table 32: Admissions and Deaths, John Hunter Hospital/John Hunter Children’s Hospital

Total Admissions 400

Survived 355 88.75% of total

Died 45 11.25% of total

Direct Admission 294 73.5% of total

Transfer In Admission 106 26.5% of total

Monthly Average 33

Table 33: Admissions by gender, John Hunter Hospital/John Hunter Children’s Hospital

Gender Count % of Total

Female 105 26.25%

Male 295 73.75%

Figure 39: Trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by age and gender

MaleFemaleTrauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

35

40

45

50

55

60

85-9475-8465-7455-6445-5435-4425-3415-240-14

12 21 21 57 7 53 11 46 7 25 8 40 11 24 16 18 12 11

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 41

Figure 40: Paediatric trauma admissions to John Hunter Children’s Hospital by age and gender

MaleFemalePaediatric trauma admissions to John Hunter Children’s Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

2

4

6

8

10

1513-1410-125-90-4

5 3 3 8 2 5 2 5 0 3

Figure 41: trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by age range and outcome (%)

Trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100

1 6 2 4 1 6 5 9 11 0

32 72 58 53 31 42 30 25 12 0

Individual Trauma Service Summaries John Hunter Hospital

42 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 42: Trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by Injury Severity Score and outcome

Trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75 0

10

20

30

40

50

60

70

80

90

100

Survived

Died

4 27 7

250 96 9

Table 34: Trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by mechanism of injury Mechanism

Mechanism % of Total

Assault 4.75%

Burns 1.25%

Fall < 1m 22.75%

Fall > 5m 4.5%

Fall 1-5m 7.75%

Horse 3%

MBC Pillion <1%

MBC Rider 14%

MVC Back Pass 2.75%

MVC Driver 18.5%

MVC Passenger (unknown location) 4%

Other 4%

Pedal Cyclist 3%

Recreation 7%

Sport <1%

Stabbing 1.25%

Individual Trauma Service Summaries John Hunter Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 43

Figure 43: Trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital

by mechanism and outcome (%)38

SurvivedDiedTrauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 23

4

17

1

99

23

57

2

93

8

12

0

23

5

31

2

Table 35: Trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by arrival mode

Arrival Mode % of Total

Ambulance 54.5%

Helicopter 33.75%

Fixed Wing 4%

NETS <1%

Private Vehicle 6.75%

Other <1%

Table 36: Trauma admissions to John Hunter Hospital/John Hunter Children’s Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 140 35%

No 260 65%

Table 37: ICU Average Length of Stay (LOS) at John Hunter Hospital/John Hunter Children’s Hospital

Outcome – All Outcome – Survived Outcome - Died

5.31 days 5.49 days 4.39 days

38 Patients transferred to another hospital are counted as survived.

Individual Trauma Service Summaries John Hunter Hospital

44 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 38: Hospital Average Length of Stay (LOS) at John Hunter Hospital/John Hunter Children’s Hospital

Outcome – All Outcome – Survived Outcome - Died

13.19 days 14.28 days 4.58 days

Table 39: Transfer In admissions to John Hunter Hospital/John Hunter Children’s Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern -

Greater Western <1%

Hunter / New England 85.8%

North Coast 11.3%

Northern Sydney / Central Coast 1.9%

South Eastern Sydney / Illawarra -

Sydney South West -

Sydney West -

Individual Trauma Service Summaries John Hunter Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 45

Liverpool Hospital Table 40: Admissions and Deaths, Liverpool Hospital

Total Admissions 275

Survived 241 87.6% of total

Died 34 12.4% of total

Direct Admission 224 81.4% of total

Transfer In Admission 51 18.6% of total

Monthly Average 23

Table 41: Admissions by gender, Liverpool Hospital

Gender Count % of Total

Female 62 22.5%

Male 213 77.5%

Figure 44: Trauma admissions to Liverpool Hospital by age and gender

MaleFemaleTrauma admissions to Liverpool Hospital by age and gender

N um

be r o

f A dm

is si

on s

Age Range

0

5

10

15

20

25

30

35

40

45

50

55

60

85-9475-8465-7455-6445-5435-4425-3415-240-14

4 12 5 52 7 35 10 34 7 24 8 22 5 13 10 18 6 3

Figure 45: Trauma admissions to Liverpool Hospital by age range and outcome (%)

Trauma admissions to Liverpool Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100

2 3 7 4 4 3 4 6 10

14 54 35 40 27 27 14 22 80

46 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 46: Trauma admissions to Liverpool Hospital by Injury Severity Score and outcome

Trauma admissions to Liverpool Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75 0

10

20

30

40

50

60

70

80

90

100

Survived

Died

5 19 21

132 88 21

Table 42: Trauma admissions to Liverpool Hospital by mechanism of injury

Mechanism % of Total

Assault 10.9%

Burns 3.3%

Fall < 1m 1.5%

Fall > 5m 4.7%

Fall 1-5m 3.6%

Horse 1.1%

Industrial 2.9%

MBC Rider 9.8%

MVC Back Pass 1.1%

MVC Driver 17.45%

MVC Front Pass 4.7%

MVC Passenger (unknown location) 2.9%

Other 2.2%

Pedal Cyclist 4%

Pedestrian 7.3%

Recreation 1.1%

Shooting 1.45%

Stabbing 2.9%

Individual Trauma Service Summaries Liverpool Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 47

Figure 47: Trauma admissions to Liverpool Hospital by mechanism and outcome (%)39

SurvivedDiedTrauma admissions to Liverpool Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 36

6

12

1

54

7

26

1

64

8

11

0

14

6

24

5

Table 43: Trauma admissions to Liverpool Hospital by arrival mode

Arrival Mode % of Total

Ambulance 81.4%

Helicopter 11.3%

Fixed Wing <1%

NETS <1%

Private Vehicle 6.2%

Table 44: Trauma admissions to Liverpool Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 135 49.1%

No 140 50.1%

Table 45: ICU Average length of stay (LOS) at Liverpool Hospital

Outcome – All Outcome – Survived Outcome - Died

8.89 days 9.59 days 3.27 days

Table 46: Hospital average length of stay at Liverpool Hospital

Outcome – All Outcome – Survived Outcome - Died

15.36 days 17.1 days 3.09 days

39 Patients transferred to another hospital are counted as survived.

Individual Trauma Service Summaries Liverpool Hospital

48 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 47: Transfer In admissions to Liverpool Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern 4%

Greater Western 4%

Hunter / New England -

North Coast -

Northern Sydney / Central Coast -

South Eastern Sydney / Illawarra 4%

Sydney South West 86%

Sydney West 2%

Individual Trauma Service Summaries Liverpool Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 49

Nepean Hospital Table 48: Admissions and Deaths, Nepean Hospital

Total Admissions 164

Survived 146 89% of total

Died 18 11% of total

Direct Admission 134 81.7% of total

Transfer In Admission 30 18.3% of total

Monthly Average 14

Table 49: Admissions by gender, Nepean Hospital

Gender Count % of Total

Female 22 13.4%

Male 142 86.6%

Figure 48: Trauma admissions to Nepean Hospital by age and gender

MaleFemaleTrauma admissions to Nepean Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

35

40

85-9475-8465-7455-6445-5435-4425-3415-240-14

1 5 4 33 1 28 3 26 5 17 2 16 2 8 3 5 1 4

Figure 49: Trauma admissions to Nepean Hospital by age range and outcome

Trauma admissions to Nepean Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100

1 1 3 5 4 0 1 1 2 0

5 36 26 24 18 18 9 7 3 0

Figure 50: Trauma admissions to Nepean Hospital by Injury Severity Score and outcome

Trauma admissions to Nepean Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

3 12 3

84 54 8

50 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Individual Trauma Service Summaries Nepean Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 51

Table 50: Trauma admissions to Nepean Hospital by mechanism of injury

Mechanism % of Total

Assault 8.5%

Burns <1%

Fall < 1m 15.2%

Fall > 5m 2.4%

Fall 1-5m 7.3%

Horse 1.8%

Industrial 3%

MBC Rider 15.2%

MVC Back Pass 1.2%

MVC Driver 21.9%

MVC Front Pass 4.9%

Other 1.2%

Pedal Cyclist 5.5%

Pedestrian <1%

Recreation <1%

Sport 1.8%

Stabbing 3%

Train <1%

Figure 51: Trauma admissions to Nepean Hospital by mechanism and outcome (%)40

SurvivedDiedTrauma admissions to Nepean Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 17 4

0

31

6

24

1

43

3

8

1

5

2

14

23

Individual Trauma Service Summaries Nepean Hospital

40 Patients transferred to another hospital are counted as survived.

Table 51: Trauma admissions to Nepean Hospital by arrival mode

Arrival Mode % of Total

Ambulance 70.7%

Helicopter 12.2%

NETS <1%%

Private Vehicle 7.9%

Other 8.5%

Table 52: Trauma admissions to Nepean Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 71 43.3%

No 93 56.7%

Table 53: ICU average length of stay (LOS) at Nepean Hospital

Outcome – All Outcome – Survived Outcome - Died

7.94 days 8.34 days 6 days

Table 54: Hospital average length of stay (LOS) at Nepean Hospital

Outcome – All Outcome – Survived Outcome - Died

15.6 days 16.82 days 5.78 days

Table 55: Transfer In admissions to Nepean Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern 3.3%

Greater Western 30%

Hunter / New England -

North Coast 3.3%

Northern Sydney / Central Coast 3.3%

South Eastern Sydney / Illawarra 3.3%

Sydney South West -

Sydney West 56.7%

52 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Individual Trauma Service Summaries Nepean Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 53

Prince of Wales Hospital Table 56: Admissions and Deaths, Prince of Wales Hospital

Total Admissions 71

Survived 66 93% of total

Died 5 7% of total

Direct Admission 34 47.9% of total

Transfer In Admission 37 52.1% of total

Monthly Average 6

Table 57: Admissions by gender, Prince of Wales Hospital

Gender Count % of Total

Female 20 28.2%

Male 51 71.8%

Figure 52: Trauma admissions to Prince of Wales Hospital by age and gender

MaleFemaleTrauma admissions to Prince of Wales Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

4

8

12

16

20

85-9475-8465-7455-6445-5435-4425-3415-240-14

0 1 4 16 1 7 0 7 3 6 3 7 3 3 5 2 1 2

Figure 53: Trauma admissions to Prince of Wales Hospital by age range and outcome (%)

Trauma admissions to Prince of Wales Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100

0 0 2 0 0 0 1 1 10

1 20 6 7 9 10 5 6 20

Figure 54: Trauma admissions to Prince of Wales Hospital by Injury Severity Score and outcome

Trauma admissions to Prince of Wales Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

2 1 2

33 32 1

54 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Individual Trauma Service Summaries Prince of Wales Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 55

Table 58: Trauma admissions to Prince of Wales Hospital by mechanism of injury

Mechanism % of Total

Assault 4.2%

Burns 2.8%

Fall < 1m 12.7%

Fall > 5m 5.6%

Fall 1-5m 9.9%

Horse 1.4%

MBC Pillion 1.4%

MBC Rider 8.4%

MVC Back Pass 4.2%

MVC Driver 14.1%

MVC Passenger (unknown location) 7%

Other 1.4%

Pedal Cyclist 8.4%

Recreation 7%

Pedestrian 7%

Sport 1.4%

Stabbing 2.8%

Figure 55: Trauma admissions to Prince of Wales Hospital by mechanism and outcome (%)41

SurvivedDiedTrauma admissions to Prince of Wales Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 5

0

3

1

16

0

6

1

19

0

5

0

2

3

10

0

Individual Trauma Service Summaries Prince of Wales Hospital

41 Patients transferred to another hospital are counted as survived.

56 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 59: Trauma admissions to Prince of Wales Hospital by arrival mode

Arrival Mode % of Total

Ambulance 43.7%

Helicopter 19.7%

Fixed wing 31%

Private Vehicle 4.2%

Other 1.4%

Table 60: Trauma Admissions to Prince of Wales Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 32 45.1%

No 39 54.9%

Table 61: ICU average length of stay at Prince of Wales Hospital

Outcome – All Outcome – Survived Outcome - Died

11.88 days 12.1 days 5 days

Table 62: Hospital length of stay (LOS) at Prince of Wales Hospital

Outcome – All Outcome – Survived Outcome - Died

24.15 days 25.79 days 2.6 days

Table 63: Transfer In admissions to Prince of Wales Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern 37.5%

Greater Western 94%

Hunter / New England 6.25%

North Coast 18.75%

Northern Sydney / Central Coast 3.1%

South Eastern Sydney / Illawarra 12.5%

Sydney South West 9.4%

Sydney West 3.1%

Individual Trauma Service Summaries Prince of Wales Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 57

Royal North Shore Hospital Table 64: Admissions and Deaths, Royal North Shore Hospital

Total Admissions 318

Survived 270 84.9% of total

Died 48 15.1% of total

Direct Admission 168 52.8% of total

Transfer In Admission 150 47.2% of total

Monthly Average 26

Table 65: Admissions by gender, Royal North Shore Hospital

Gender Count % of Total

Female 91 28.6%

Male 227 71.4%

Figure 56: Trauma admissions to Royal North Shore Hospital by age and gender42

MaleFemaleTrauma admissions to Royal North Shore Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

35

40

45

50

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

0 1 10 40 7 33 6 30 9 31 10 26 8 21 29 29 11 15 1 1

42 Excludes 1 record where age not specifi ed

58 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 57: Trauma admissions to Royal North Shore Hospital by age range and outcome (%)42

Trauma admissions to Royal North Shore Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100

0 9 4 6 5 7 9 9 4 0

1 41 36 30 35 29 26 49 22 1

Figure 58: Trauma admissions to Royal North Shore Hospital by Injury Severity Score and outcome

Trauma admissions to Royal North Shore Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

2 31 15

156 101 13

Individual Trauma Service Summaries Royal North Shore Hospital

42 Excludes 1 record where age not specifi ed

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 59

Table 66: Trauma admissions to Royal North Shore Hospital by mechanism of injury

Mechanism % of Total

Assault 4.7%

Burns 4.1%

Fall < 1m 28.6%

Fall > 5m 2.2%

Fall 1-5m 19.2%

Horse <1%

MBC Pillion <1%

MBC Rider 5.3%

MVC Back Pass 1.9%

MVC Driver 8.8%

MCV Front Pass <1%

Other 5.3%

Pedal Cyclist 3.5%

Pedestrian 8.8%

Recreation <1%

shooting <1%

Sport 3.1%

Stabbing <1%

Train <1%

Unknown 1.3%

Figure 59: Trauma admissions to Royal North Shore Hospital by mechanism and outcome (%)43

SurvivedDiedTrauma admissions to Royal North Shore Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 15 5 129 17 31 11 21 41

2 2 23 1 5 0 7 8

Individual Trauma Service Summaries Royal North Shore Hospital

43 Patients transferred to another hospital are counted as survived.

60 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 67: Trauma admissions to Royal North Shore Hospital by arrival mode

Arrival Mode % of Total

Ambulance 64.1%

Helicopter 20.1%

Fixed wing 8.8%

Private Vehicle 5.3%

Other 1.6%

Table 68: Trauma admissions to Royal North Shore Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 151 47.5%

No 167 52.5%

Table 69: ICU average length of stay at Royal North Shore Hospital

Outcome – All Outcome – Survived Outcome - Died

8.03 days 8.17 days 7.37 days

Table 70: Hospital average length of stay (LOS) at Royal North Shore Hospital

Outcome – All Outcome – Survived Outcome - Died

22.57 days 25.64 days 5.33 days

Table 71: Transfer In admissions to Royal North Shore Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern -

Greater Western 4.9%

Hunter / New England 15.3%

North Coast 9%

Northern Sydney / Central Coast 65.3%

South Eastern Sydney / Illawarra <1%

Sydney South West 2.1%

Sydney West 2.8%

Individual Trauma Service Summaries Royal North Shore Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 61

Royal Prince Alfred Hospital Table 72: Admissions and Deaths, Royal Prince Alfred Hospital

Total Admissions 201

Survived 173 86.1% of total

Died 28 13.9% of total

Direct Admission 162 80.6% of total

Transfer In Admission 39 19.4% of total

Monthly Average 17

Table 73: Admissions by gender, Royal Prince Alfred Hospital

Gender Count % of Total

Female 47 23.4%

Male 154 76.6%

Figure 60: Trauma admissions to Royal Prince Alfred Hospital by age and gender

MaleFemaleTrauma admissions to Royal Prince Alfred Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

35

40

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

1 1 5 28 2 38 4 15 4 25 4 11 10 18 8 13 8 4 1 1

62 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 61: Trauma admissions to Royal Prince Alfred Hospital by age range and outcome (%)

Trauma admissions to Royal Prince Alfred Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100

0 2 6 2 3 1 4 3 7 0

2 31 34 17 26 14 24 18 5 2

Figure 62: Trauma admissions to Royal Prince Alfred Hospital by Injury Severity Score and Outcome

Trauma admissions to Royal Prince Alfred Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

2 19 7

115 49 9

Individual Trauma Service Summaries Royal Prince Alfred Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 63

Table 74: Trauma admissions to Royal Prince Alfred Hospital by mechanism of injury

Mechanism % of Total

Assault 10.9%

Burns <1%

Fall < 1m 33.3%

Fall > 5m 2.5%

Fall 1-5m 9.4%

Horse 1.5%

Industrial <1%

MBC Rider 5.5%

MVC Back Pass 1%

MVC Driver 9%

MCV Front Pass 2%

Other 1.5%

Pedal Cyclist 2%

Pedestrian 14.4%

Recreation <1%

shooting <1%

Sport <1%

Stabbing 4%

Unknown <1%

Figure 63: Trauma admissions to Royal Prince Alfred Hospital by mechanism and outcome (%)44

SurvivedDiedTrauma admissions to Royal Prince Alfred Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 29

2

4

1

69

17

11

0

21

3

4

0

25

4

10

1

Individual Trauma Service Summaries Royal Prince Alfred Hospital

44 Patients transferred to another hospital are counted as survived.

64 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 75: Trauma admissions to Royal Prince Alfred Hospital by arrival mode

Arrival Mode % of Total

Ambulance 72.6%

Helicopter 14.4%

Fixed wing <1%

Private Vehicle 9%

Other 3.5%

Table 76: Trauma admissions to Royal Prince Alfred Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 106 52.7%

No 95 47.3%

Table 77: ICU average length of stay (LOS) at Royal Prince Alfred Hospital

Outcome – All Outcome – Survived Outcome - Died

6.41 days 6.93 days 3.83 days

Table 78: Hospital average length of stay (LOS) at Royal Prince Alfred Hospital

Outcome – All Outcome – Survived Outcome - Died

12.68 days 14.03 days 4.36 days

Table 79: Transfer In admissions to Royal Prince Alfred Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern 10.5%

Greater Western 47.4%

Hunter / New England 2.6%

North Coast 7.9%

Northern Sydney / Central Coast 5.3%

South Eastern Sydney / Illawarra 2.6%

Sydney South West 23.7%

Sydney West -

Individual Trauma Service Summaries Royal Prince Alfred Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 65

St George Hospital Table 80: Admissions and Deaths, St George Hospital

Total Admissions 228

Survived 201 88.2% of total

Died 27 11.8% of total

Direct Admission 169 74.1% of total

Transfer In Admission 59 25.9% of total

Monthly Average 19

Table 81: Admissions by gender, St George Hospital

Gender Count % of Total

Female 58 25.4%

Male 170 74.6%

Figure 64: Trauma admissions to St George Hospital by age and gender

MaleFemaleTrauma admissions to St George Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

35

40

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

4 1 8 26 4 31 5 19 3 16 7 23 9 27 14 17 4 9 0 1

66 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 65: Trauma admissions to St George Hospital by age range and outcome (%)

Trauma admissions to St George Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-240-14

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100

0 0 3 2 1 2 6 9 3 1

5 34 32 22 18 28 30 22 10 0

Figure 66: Trauma admissions to St George Hospital by Injury Severity Score and Outcome

Trauma admissions to St George Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

6 14 7

130 57 14

Individual Trauma Service Summaries St George Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 67

Table 82: Trauma admissions to St George Hospital by mechanism of injury

Mechanism % of Total

Assault 4.4%

Burns 1.3%

Fall < 1m 16.7%

Fall > 5m 6.1%

Fall 1-5m 15.3%

Horse <1%

Industrial <1%

MBC Rider 7.9%

MVC Back Pass 2.6%

MVC Driver 14.9%

MCV Front Pass 4.4%

MCV Front Passenger (unknown location) <1%

Other 2.6%

Pedal Cyclist 3.1%

Pedestrian 11.4%

shooting <1%

Sport 2.2%

Stabbing 3.9%

Train <1%

Figure 67: Trauma admissions to St George Hospital by mechanism and outcome (%)45

SurvivedDiedTrauma admissions to St George Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 19

1

14

0

57

16

18

0

46

5

7

0

21

5

19

0

Individual Trauma Service Summaries St George Hospital

45 Patients transferred to another hospital are counted as survived.

68 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 83: Trauma admissions to St George Hospital by arrival mode

Arrival Mode % of Total

Ambulance 69.7%

Helicopter 11.8%

Fixed wing 11.8%

Private Vehicle 6.1%

Other <1%

Table 84: Trauma admissions to St George Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 88 38.6%

No 140 61.4%

Table 85: ICU average length of stay (LOS) at St George Hospital

Outcome – All Outcome – Survived Outcome - Died

7.57 days 7.97 days 5.23 days

Table 86: Hospital average length of stay (LOS) at St George Hospital

Outcome – All Outcome – Survived Outcome - Died

17.52 days 18.98 days 6.7 days

Table 87: Transfer In admissions to St George Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern 13.8%

Greater Western 8.6%

Hunter / New England 1.7%

North Coast 13.8%

Northern Sydney / Central Coast 1.7%

South Eastern Sydney / Illawarra 53.4%

Sydney South West 1.7%

Sydney West 5.2%

Individual Trauma Service Summaries St George Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 69

St Vincent’s Hospital Table 88: Admissions and Deaths, St Vincent’s Hospital

Total Admissions 130

Survived 118 90.8% of total

Died 12 9.2% of total

Direct Admission 124 95.4% of total

Transfer In Admission 6 4.6% of total

Monthly Average 11

Table 89: Admissions by gender, St Vincent’s Hospital

Gender Count % of Total

Female 42 32.3%

Male 88 67.7%

Figure 68: Trauma admissions to St Vincent’s Hospital by age and gender

MaleFemaleTrauma admissions to St Vincent’s Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

35

40

85-9475-8465-7455-6445-5435-4425-3415-24

7 17 5 29 4 12 5 9 4 3 3 5 7 5 7 8

70 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 69: Trauma admissions to St Vincent’s Hospital by age range and outcome

Trauma admissions to St Vincent’s Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

85-9475-8465-7455-6445-5435-4425-3415-24

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100 22 31 14 13 5 8 12 13

2 3 2 1 2 0 0 2

Figure 70: Trauma admissions to St Vincent’s Hospital by Injury Severity Score and Outcome

Trauma admissions to St Vincent’s Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

1 8 3

79 35 4

Individual Trauma Service Summaries St Vincent’s Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 71

Table 90: Trauma admissions to St Vincent’s Hospital by mechanism of injury

Mechanism % of Total

Assault 14.6%

Burns 1.5%

Fall < 1m 16.9%

Fall > 5m 8.5%

Fall 1-5m 18.5%

Iindustrial <1%

MBC Rider 3.8%

MVC Back Pass 1.5%

MVC Driver 4.6%

MCV Front Pass <1%

Other 3.8%

Pedestrian 19.2%

shooting <1%

Sport <1%

Stabbing 3.1%

Unknown <1%

Figure 71: Trauma admissions to St Vincent’s Hospital by mechanism and outcome (%)46

SurvivedDiedTrauma admissions to St Vincent’s Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianMVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 22 9 42 5 9 23 8

2 2 4 0 0 2 2

Individual Trauma Service Summaries St Vincent’s Hospital

46 Patients transferred to another hospital are counted as survived.

72 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 91: Trauma admissions to St Vincent’s Hospital by arrival mode

Arrival Mode % of Total

Ambulance 71.5%

Fixed wing <1%

Private Vehicle 4.6%

Other 23.1%

Table 92: Trauma admissions to St Vincent’s Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 66 50.8%

No 64 49.2%

Table 93: ICU average length of stay (LOS) at St Vincent’s Hospital

Outcome – All Outcome – Survived Outcome - Died

7.77 days 7.66 days 9.5 days

Table 94: Hospital average length of stay at St Vincent’s Hospital

Outcome – All Outcome – Survived Outcome - Died

18.95 days 20.47 days 4.08 days

Table 95: Transfer In admissions to St Vincent’s Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern 33.3%

Greater Western -

Hunter / New England 16.7%

North Coast 16.7%

Northern Sydney / Central Coast -

South Eastern Sydney / Illawarra 33.3%

Sydney South West -

Sydney West -

Individual Trauma Service Summaries St Vincent’s Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 73

Sydney Children’s Hospital

Table 96: Admissions and Deaths, Sydney Children’s Hospital

Total Admissions 49

Survived 47 95.9% of total

Died 2 4.1% of total

Direct Admission 13 26.5% of total

Transfer In Admission 36 73.5% of total

Monthly Average 4

Table 97: Admissions by gender, Sydney Children’s Hospital

Gender Count % of Total

Female 16 32.6%

Male 33 67.4%

Figure 72: Paediatric trauma admissions to Sydney Children’s Hospital by age and gender

Paediatric trauma admissions to Sydney Children’s Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

1513-1410-125-90-4

MaleFemale

0

5

10

15

20

11 14 4 5 0 6 1 6 0 2

74 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 73: Trauma admissions to Sydney Children’s Hospital by age range and outcome (%)

Trauma admissions to Sydney Children’s Hospital by age range and outcome (%)

% o

f a dm

is si

on s

Age range

0-14 15

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

2 0

45 2

Figure 74: Trauma admissions to Sydney Children’s Hospital by Injury Severity Score and outcome

Trauma admissions to Sydney Children’s Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

0 1 1

24 17 6

Individual Trauma Service Summaries Sydney Children’s Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 75

Table 98: Trauma admissions to Sydney Children’s Hospital by mechanism of injury

Mechanism % of Total

Assault 2%

Burns 2%

Fall < 1m 6.1%

Fall > 5m 4.1%

Fall 1-5m 22.4%

MBC Rider 2%

MVC Back Pass 8.2%

MVC Driver 2%

Other 8.2%

Pedal Cyclist 14.3%

Pedestrian 26.5%

Recreation 2%

Figure 75: Trauma admissions to Sydney Children’s Hospital by mechanism and outcome (%)47

SurvivedDiedTrauma admissions to Sydney Children’s Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 1

0

2

0

14

0

1

0

5

0

7

0

12

1

5

1

Table 99: Trauma admissions to Sydney Children’s Hospital by arrival mode

Arrival Mode % of Total

Ambulance 14.3%

Fixed wing 12.2%

NETS 20.4

Private Vehicle 40.8%

Other 12.2%

Individual Trauma Service Summaries Sydney Children’s Hospital

47 Patients transferred to another hospital are counted as survived.

76 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 100: Trauma admissions to Sydney Children’s Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 34 69.4%

No 15 30.6%

Table 101: ICU average length of stay (LOS) at Sydney Children’s Hospital

Outcome – All Outcome – Survived Outcome - Died

3.85 days 3.88 days 3 days

Table 102: Hospital average length of stay (LOS) at Sydney Children’s Hospital

Outcome – All Outcome – Survived Outcome - Died

13.41 days 13.89 days 2 days

Table 103: Transfer In admissions to Sydney Children’s Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern 5.9%

Greater Western 14.7%

Hunter / New England -

North Coast 11.8%

Northern Sydney / Central Coast 17.6%

South Eastern Sydney / Illawarra 29.4%

Sydney South West 14.7%

Sydney West 5.9%

Individual Trauma Service Summaries Sydney Children’s Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 77

The Children’s Hospital at Westmead Table 104: Admissions and Deaths, The Children’s Hospital at Westmead

Total Admissions 76

Survived 71 93.4% of total

Died 5 6.6% of total

Direct Admission 29 38.2% of total

Transfer In Admission 47 61.8% of total

Monthly Average 6

Table 105: Admissions by gender, The Children’s Hospital at Westmead

Gender Count % of Total

Female 23 30.3%

Male 53 69.7%

Figure 76: Paediatric trauma admissions to The Children’s Hospital at Westmead for by age and gender

Paediatric trauma admissions to The Children’s Hospital at Westmead by age and gender

N um

be r

of a

dm is

si on

s

Age range

0

5

10

15

20

10 14 6 15 2 9 2 13 3 2

0-4 5-9 10-12 13-14 15

MaleFemale

78 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 77: Trauma admissions to the Children’s Hospital at Westmead by age range and outcome (%)

Trauma admissions to The Children’s Hospital at Westmead by age range and outcome (%)

% o

f a dm

is si

on s

Age range

0-14 15

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

5 0

66 5

Figure 78: Trauma admissions to The Children’s Hospital at Westmead by Injury Severity Score and Outcome

Trauma admissions to The Children’s Hospital at Westmead by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

0 3 2

51 20 0

Individual Trauma Service Summaries The Children’s Hospital at Westmead

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 79

Table 106: Trauma admissions to The Children’s Hospital at Westmead by mechanism of injury

Mechanism % of Total

Assault 2.6%

Burns 15.8%

Fall < 1m 15.8%

Fall > 5m 3.9%

Fall 1-5m 1.3%

Fall Unspecifi ed Height 1.3%

Horse 3.9%

MBC Rider 5.3%

MVC Back Pass 1.3%

MVC Driver 1.3%

MVC Front Pass 1.3%

MVC Passenger (unknown location) 15.8%

Other 5.3%

Pedal Cyclist 9.2%

Pedestrian 11.8%

Recreation 3.9%

Figure 79: Trauma admissions to The Children’s Hospital at Westmead by mechanism and outcome (%)48

SurvivedDiedTrauma admissions to The Children’s Hospital at Westmead by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 2

0

2

1

13

0

4

0

12

3

7

0

8

1

22

0

Individual Trauma Service Summaries The Children’s Hospital at Westmead

48 Patients transferred to another hospital are counted as survived. Chart excludes one survived patient from fall of unspecifi ed height.

80 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 107: Trauma admissions to The Children’s Hospital at Westmead by arrival mode

Arrival Mode % of Total

Ambulance 35.5%

Helicopter 7.9%

Fixed wing 3.9%

NETS 42.1%

Private Vehicle 10.5%

Table 108: Trauma admissions to The Children’s Hospital at Westmead by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 44 57.9%

No 32 42.1%

Table 109: ICU average length of stay (LOS) at The Children’s Hospital at Westmead

Outcome – All Outcome – Survived Outcome - Died

6.05 days 6.38 days 2.75 days

Table 110: Hospital average length of stay (LOS) at The Children’s Hospital at Westmead

Outcome – All Outcome – Survived Outcome - Died

15.32 16.23 days 2.4 days

Table 111: Transfer In admissions to The Children’s Hospital at Westmead by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern 8.9%

Greater Western 8.9%

Hunter / New England 8.9%

North Coast 2.2%

Northern Sydney / Central Coast 13.3%

South Eastern Sydney / Illawarra 13.3%

Sydney South West 22.2%

Sydney West 22.2%

Individual Trauma Service Summaries The Children’s Hospital at Westmead

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 81

Westmead Hospital Table 112: Admissions and Deaths, Westmead Hospital

Total Admissions 330

Survived 189 87.6% of total

Died 41 12.4% of total

Direct Admission 262 79.4% of total

Transfer In Admission 68 20.6% of total

Monthly Average 27

Table 113: Admissions by gender, Westmead Hospital

Gender Count % of Total

Female 95 28.8%

Male 235 71.2%

Figure 80: Trauma admissions to Westmead Hospital by age and gender

MaleFemaleTrauma admissions to Westmead Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

35

40

45

50

55

60

95+85-9475-8465-7455-6445-5435-4425-3415-24

14 54 11 39 10 39 12 24 4 30 6 21 20 23 14 5 4 0

Individual Trauma Service Summaries Westmead Hospital

82 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 81: Trauma admissions to Westmead Hospital by age range and outcome (%)

Trauma admissions to Westmead Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-24

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100 62 43 45 31 32 24 38 11 3

6 7 4 5 2 3 5 8 1

Figure 82: Trauma admissions to Westmead Hospital by Injury Severity Score and outcome

Trauma admissions to Westmead Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

8 21 12

166 105 18

Individual Trauma Service Summaries Westmead Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 83

Table 114: Trauma admissions to Westmead Hospital by mechanism of injury

Mechanism % of Total

Assault 6.1%

Burns <1%

Fall < 1m 18.8%

Fall > 5m 2.1%

Fall 1-5m 8.2%

Fall Unspecifi ed Height <1%

Horse 1.8%

Industrial <1%

MBC Pillion <1%

MBC Rider 10.6%

MVC Back Pass 2.4%

MVC Driver 21.8%

MVC Front Pass 5.1%

Other 2.4%

Pedal Cyclist 2.7%

Pedestrian 9.4%

Shooting 1.5%

Sport 2.1%

Stabbing 3.6%

Figure 83: Trauma admissions to Westmead Hospital by mechanism and outcome (%)49

SurvivedDiedTrauma admissions to Westmead Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 26

11

6

1

76

13

34

2

89

8

9

0

25

6

23

0

49 Patients transferred to another hospital are counted as survived. Chart excludes one survived patient from fall of unspecifi ed height.

Individual Trauma Service Summaries Westmead Hospital

84 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 115: Trauma admissions to Westmead Hospital by arrival mode

Arrival Mode % of Total

Ambulance 74.5%

Helicopter 19.7%

Fixed wing 1.2%

Private Vehicle 3.9%

Other <1%

Table 116: Trauma admissions to Westmead Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 104 31.5%

No 226 68.5%

Table 117: ICU average length of stay (LOS) at Westmead Hospital

Outcome – All Outcome – Survived Outcome - Died

8.87 days 9.27 days 6.94 days

Table 118: Hospital average length of stay (LOS) at Westmead Hospital

Outcome – All Outcome – Survived Outcome - Died

16.13 days 17.66 days 5.32 days

Table 119: Transfer In admissions to Westmead Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern 1.5%

Greater Western 24.2%

Hunter / New England 1.5%

North Coast 1.5%

Northern Sydney / Central Coast 6.1%

South Eastern Sydney / Illawarra 4.5%

Sydney South West -

Sydney West 60.6%

Individual Trauma Service Summaries Westmead Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 85

Wollongong Hospital

Table 120: Admissions and Deaths, Wollongong Hospital

Total Admissions 106

Survived 91 85.85% of total

Died 15 14.15% of total

Direct Admission 96 90.6% of total

Transfer In Admission 10 9.4% of total

Monthly Average 9

Table 121: Admissions by gender, Wollongong Hospital

Gender Count % of Total

Female 16 15.1%

Male 90 84.9%

Figure 84: Trauma admissions to Wollongong Hospital by age and gender

MaleFemaleTrauma admissions to Wollongong Hospital by age and gender

N um

be r

of A

dm is

si on

s

Age Range

0

5

10

15

20

25

30

85-9475-8465-7455-6445-5435-4425-3415-240-14

2 7 3 21 0 18 0 11 1 13 3 7 3 4 3 3 1 6

86 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 85: Trauma admissions to Wollongong Hospital by age range and outcome (%)

Trauma admissions to Wollongong Hospital by age range and outcome (%)

% o

f A dm

is si

on s

Age Range

95+85-9475-8465-7455-6445-5435-4425-3415-24

SurvivedDied

0

10

20

30

40

50

60

70

80

90

100 8 20 16 10 13 9 4 5 6

1 4 2 1 1 1 3 1 1

Figure 86: Trauma admissions to Wollongong Hospital by Injury Severity score and outcome

Trauma admissions to Wollongong Hospital by ISS and outcome

% o

f a dm

is si

on s

ISS Range

16-24 25-40 41-75

Survived

Died

0

10

20

30

40

50

60

70

80

90

100

2 7 6

58 30 3

Individual Trauma Service Summaries Wollongong Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 87

Table 122: Trauma admissions to Wollongong Hospital by mechanism of injury

Mechanism % of Total

Assault 9.4%

Burns 1.9%

Fall < 1m 14.1%

Fall > 5m 1.9%

Fall 1-5m 17%

Fall Unspecifi ed Height <1%

MBC Rider 21.7%

MVC Driver 9.4%

MVC Front Pass <1%

MVC Passenger (unknown location) 4.7%

Other <1%

Pedal Cyclist 4.7%

Pedestrian 6.6%

Recreation 2.8%

Shooting <1%

Stabbing 1.9%

Figure 87: Trauma admissions to Wollongong Hospital by mechanism and outcome (%)50

SurvivedDiedTrauma admissions to Wollongong Hospital by mechanism of injury and outcome (%)

% o

f A dm

is si

on s

Mechanism of Injury

All other injuries

PedestrianPedal Cyclist

MVCMBCLow/Medium Falls (<5m)

High Falls (>5m)

Assault 0

10

20

30

40

50

60

70

80

90

100 12

1

2

0

30

3

22

1

11

5

5

0

5

2

4

2

Individual Trauma Service Summaries Wollongong Hospital

50 Patients transferred to another hospital are counted as survived. Chart excludes one death from fall from unspecifi ed height.

88 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 123: Trauma admissions to Wollongong Hospital by arrival mode

Arrival Mode % of Total

Ambulance 81.1%

Helicopter 8.5%

Private Vehicle 6.6%

Other 3.8%

Table 124: Trauma admissions to Wollongong Hospital by ICU admission

Admission to ICU Number of Admissions % of Total

Yes 24 22.5%

No 82 68.5%

Table 125: ICU average length of stay (LOS) at Wollongong Hospital

Outcome – All Outcome – Survived Outcome - Died

9.83 days 11.63 days 3 days

Table 126: Hospital average length of stay (LOS) at Wollongong Hospital

Outcome – All Outcome – Survived Outcome - Died

11.25 days 12.78 days 2 days

Table 127: Transfer In admissions to Wollongong Hospital by Area Health Service

Transferring Area Health Service % of Transfers

Greater Southern -

Greater Western -

Hunter / New England -

North Coast -

Northern Sydney / Central Coast -

South Eastern Sydney / Illawarra 100%

Sydney South West -

Sydney West -

Individual Trauma Service Summaries Wollongong Hospital

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 89

Appendix NSW Trauma System - Minimum Data Set

All trauma admissions with ISS > 15 or ICU Admission or death (Excluding #NOF Death)

Data Collection Form

Hospital Name

Gender male / female Age

Residential Postcode Injury Postcode

Date of Injury Time of Injury

Mechanism

Place of Injury Home/Not at Home

Date of arrival (At your hospital) Time of arrival (At your hospital)

Mode of arrival (At your hospital)

Transfer in yes / no

Transfer From

Op suite at 1st hospital yes / no

If Yes, Type of OS at 1st Hospital

Transfer out yes / no

Transferred to

Transfer out Reason Burns, Paediatric, Spinal, Other

Op Suite 1st 24 hrs yes / no

If yes, Type of OS

ICU admit yes / no ICU LOS Patient days

Outcome survived / died

AIS body regions

ISS

Length of Stay Total Hospital LOS in Patient days

Data Dictionary

MechanismMVC driver, MVC pass, MBC rider, MBC pillion, Pedestrian, Pedal Cyclist, fall<1m, fall 1-5m, fall>5m, shooting, stabbing, blunt assault, organised sport, recreational sport, burns, Industrial - includes all work related, Horse, Other - specify

Mode of arrivalAmbulance, Helicopter, Private vehicle, Fixed Wing, NETS, Other

AIS body regionslist 3 most injured i.e. the ones used to calculate the ISS

Type of OScraniotomy, thoracotomy, laparotomy, open ext#, other – specify

Length of stayIf LOS is > 6 weeks then put >42 days

90 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Index of Tables Table 1:Trauma Service (TS)

Admissions and Deaths ................................ 7

Table 2:Admissions by Gender ................................. 8

Table 3:Outcome by Gender .................................... 8

Table 4:Admissions by Area Health Service ............... 9

Table 5:Geographical Location of injury by Area Health

Service (people injured) ................................ 10

Table 6:Age - Top 3 Age Ranges .............................. 10

Table 7:Mechanism of Injury - Road Trauma ............. 11

Table 8:Mechanism of Injury - Falls ........................... 12

Table 9:Mechanism of Injury - Assaults ..................... 12

Table 10:Admission Type ............................................ 12

Table 11:Outcome by Admission Type ........................ 12

Table 12:ICU Admissions ............................................ 13

Table 13:ICU Admission by Outcome ......................... 13

Table 14:ICU Average Length of Stay (LOS) ................ 13

Table 15:Hospital Average Length of Stay (LOS) ......... 14

Table 16:Arrival Mode - Top 3 Arrival Modes .............. 14

Table 17:Operating Suite in First 24 Hours - Top 3

Procedures ................................................... 15

Table 18:Injury Time - Top 3 Hours of the Day Injury

Occurred (excludes patients where time of

injury is unknown) ....................................... 16

Table 19:Admission Time - Top 3 Hours of the Day of

Admission to Defi nitive Trauma Hospital ...... 16

Table 20:Injury Day of Week ...................................... 17

Table 21:Injury Severity Score (ISS) ............................. 17

Table 22: Time to defi nitive care for patients admitted

directly to a defi nitive trauma hospital, rural vs

metropolitan location of injury ..................... 18

Table 23: Time to defi nitive care for patients transferred

to a defi nitive trauma hospital, rural vs

metropolitan location of injury ..................... 19

Table 24:Admissions and Deaths,

Gosford Hospital .......................................... 36

Table 25:Admissions by gender,

Gosford Hospital .......................................... 36

Table 26:Trauma admissions to Gosford Hospital by

mechanism of injury .................................... 38

Table 27:Trauma admissions to Gosford Hospital by

Arrival Mode ................................................ 39

Table 28:Trauma admissions at Gosford Hospital by

ICU admission .............................................. 39

Table 29:CU Average Length of Stay (LOS) at

Gosford Hospital .......................................... 39

Table 30:Hospital Average Length of Stay at

Gosford Hospital .......................................... 39

Table 31:Transfer In Admissions to Gosford Hospital

Area Health Service ...................................... 39

Table 32:Admissions and Deaths, John Hunter Hospital/

by ohn Hunter Children’s Hospital ................ 40

Table 33:Admissions by gender, John Hunter Hospital/

John Hunter Children’s Hospital ................... 40

Table 34:Trauma admissions to John Hunter Hospital/

John Hunter Children’s Hospital by mechanism

of injury ....................................................... 42

Table 35:Trauma admissions to John Hunter Hospital /

John Hunter Children’s Hospital by arrival

mode ........................................................... 43

Table 36:Trauma admissions to John Hunter Hospital /

John Hunter Children’s Hospital by ICU

admission .................................................... 43

Table 37:ICU Average Length of Stay (LOS) at

John Hunter Hospital / John Hunter

Children’s Hospital ....................................... 43

Table 38:Hospital Average Length of Stay (LOS)

at John Hunter Hospital / John Hunter

Children’s Hospital ....................................... 44

Table 39:Transfer In admissions to John Hunter

Hospital/John Hunter Children’s Hospital by

Area Health Service ...................................... 44

Table 40:Admissions and Deaths, Liverpool Hospital ... 45

Table 41:Admissions by gender, Liverpool Hospital ..... 45

Table 42:Trauma admissions to Liverpool Hospital by

mechanism of injury .................................... 46

Table 43:Trauma admissions to Liverpool Hospital by

arrival mode ................................................ 47

Table 44:Trauma admissions to Liverpool Hospital by

ICU admission .............................................. 47

Table 45:ICU Average length of stay (LOS) at

Liverpool Hospital ........................................ 47

Table 46:Hospital average length of stay at

Liverpool Hospital ........................................ 47

Table 47:Transfer In admissions to Liverpool Hospital

by Area Health Service ................................. 48

Table 48:Admissions and Deaths, Nepean Hospital ..... 49

Table 49:Admissions by gender, Nepean Hospital ....... 49

Table 50:Trauma admissions to Nepean Hospital by

mechanism of injury .................................... 51

Table 51:Trauma admissions to Nepean Hospital by

arrival mode ................................................ 52

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 91

Table 52:Trauma admissions to Nepean Hospital by

ICU admission .............................................. 52

Table 53:ICU average length of stay (LOS) at

Nepean Hospital .......................................... 52

Table 54:Hospital average length of stay (LOS) at

Nepean Hospital .......................................... 52

Table 55:Transfer In admissions to Nepean Hospital by

Area Health Service ...................................... 52

Table 56:Admissions and Deaths,

Prince of Wales Hospital............................... 53

Table 57:Admissions by gender,

Prince of Wales Hospital............................... 53

Table 58:Trauma admissions to Prince of Wales

Hospital by mechanism of injury .................. 55

Table 59:Trauma admissions to Prince of Wales

Hospital by arrival mode .............................. 56

Table 60:Trauma Admissions to Prince of Wales

Hospital by ICU admission ............................ 56

Table 61:ICU average length of stay at Prince of

Wales Hospital ............................................. 56

Table 62:Hospital length of stay (LOS) at Prince of

Wales Hospital ............................................. 56

Table 63:Transfer In admissions to Prince of Wales

Hospital by Area Health Service .................... 56

Table 64:Admissions and Deaths, Royal North

Shore Hospital ............................................. 57

Table 65:Admissions by gender, Royal North Shore

Hospital ....................................................... 57

Table 66:Trauma admissions to Royal North Shore

Hospital by mechanism of injury .................. 59

Table 67:Trauma admissions to Royal North Shore

Hospital by arrival mode .............................. 60

Table 68:Trauma admissions to Royal North Shore

Hospital by ICU admission ............................ 60

Table 69:ICU average length of stay at Royal North

Shore Hospital ............................................. 60

Table 70:Hospital average length of stay (LOS) at

Royal North Shore Hospital .......................... 60

Table 71:Transfer In admissions to Royal North

Shore Hospital by Area Health Service .......... 60

Table 72:Admissions and Deaths, Royal Prince Alfred

Hospital ....................................................... 61

Table 73:Admissions by gender, Royal Prince Alfred

Hospital ....................................................... 61

Table 74:Trauma admissions to Royal Prince Alfred

Hospital by mechanism of injury .................. 63

Table 75:Trauma admissions to Royal Prince Alfred

Hospital by arrival mode .............................. 64

Table 76:Trauma admissions to Royal Prince Alfred

Hospital by ICU admission ............................ 64

Table 77:ICU average length of stay (LOS) at Royal

Prince Alfred Hospital .................................. 64

Table 78:Hospital average length of stay (LOS) at

Royal Prince Alfred Hospital ......................... 64

Table 79:Transfer In admissions to Royal Prince

Alfred Hospital by Area Health Service ......... 64

Table 80:Admissions and Deaths, St George Hospital . 65

Table 81:Admissions by gender, St George Hospital ... 65

Table 82:Trauma admissions to St George Hospital by

mechanism of injury .................................... 67

Table 83:Trauma admissions to St George Hospital by

arrival mode ................................................ 68

Table 84:Trauma admissions to St George Hospital by

ICU admission .............................................. 68

Table 85:ICU average length of stay (LOS) at

St George Hospital ....................................... 68

Table 86:Hospital average length of stay (LOS) at

St George Hospital ....................................... 68

Table 87:Transfer In admissions to St George Hospital

by Area Health Service ................................. 68

Table 88:Admissions and Deaths,

St Vincent’s Hospital .................................... 69

Table 89:Admissions by gender, St Vincent’s Hospital . 69

Table 90:Trauma admissions to St Vincent’s Hospital

by mechanism of injury ................................ 71

Table 91:Trauma admissions to St Vincent’s Hospital

by arrival mode ............................................ 72

Table 92:Trauma admissions to St Vincent’s Hospital

by ICU admission ......................................... 72

Table 93:ICU average length of stay (LOS) at

St Vincent’s Hospital .................................... 72

Table 94:Hospital average length of stay at

St Vincent’s Hospital .................................... 72

Table 95:Transfer In admissions to St Vincent’s Hospital

by Area Health Service ................................. 72

Table 96:Admissions and Deaths,

Sydney Children’s Hospital ........................... 73

Table 97:Admissions by gender,

Sydney Children’s Hospital ........................... 73

Table 98:Trauma admissions to Sydney Children’s

Hospital by mechanism of injury .................. 75

92 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Table 99:Trauma admissions to Sydney Children’s

Hospital by arrival mode ............................ 75

Table 100:Trauma admissions to Sydney Children’s

Hospital by ICU admission ......................... 76

Table 101:ICU average length of stay (LOS) at

Sydney Children’s Hospital ......................... 76

Table 102:Hospital average length of stay (LOS) at

Sydney Children’s Hospital ......................... 76

Table 103:Transfer In admissions to Sydney Children’s

Hospital by Area Health Service.................. 76

Table 104:Admissions and Deaths,

The Children’s Hospital at Westmead ......... 77

Table 105:Admissions by gender,

The Children’s Hospital at Westmead ......... 77

Table 106:Trauma admissions to The Children’s

Hospital at Westmead by

mechanism of injury .................................. 79

Table 107:Trauma admissions to The Children’s Hospital

at Westmead by arrival mode .................... 80

Table 108:Trauma admissions to The Children’s Hospital

at Westmead by ICU admission.................. 80

Table 109:ICU average length of stay (LOS) at

The Children’s Hospital at Westmead ......... 80

Table 110:Hospital average length of stay (LOS) at

The Children’s Hospital at Westmead ......... 80

Table 111:Transfer In admissions to The Children’s

Hospital at Westmead by

Area Health Service.................................... 80

Table 112:Admissions and Deaths,

Westmead Hospital.................................... 81

Table 113:Admissions by gender, Westmead Hospital 81

Table 114:Trauma admissions to Westmead Hospital

by mechanism of injury .............................. 83

Table 115:Trauma admissions to Westmead Hospital by

arrival mode .............................................. 84

Table 116:Trauma admissions to Westmead Hospital

by ICU admission ......................................... 84

Table 117:ICU average length of stay (LOS) at

Westmead Hospital.................................... 84

Table 118:Hospital average length of stay (LOS) at

Westmead Hospital.................................... 84

Table 119:Transfer In admissions to Westmead Hospital

by Area Health Service ............................... 84

Table 120:Admissions and Deaths,

Wollongong Hospital ................................. 85

Table 121:Admissions by gender,

Wollongong Hospital ................................. 85

Table 122:Trauma admissions to Wollongong Hospital

by mechanism of injury .............................. 87

Table 123:Trauma admissions to Wollongong Hospital

by arrival mode .......................................... 88

Table 124:Trauma admissions to Wollongong Hospital

by ICU admission ....................................... 88

Table 125:ICU average length of stay (LOS) at

Wollongong Hospital ................................. 88

Table 126:Hospital average length of stay (LOS) at

Wollongong Hospital ................................. 88

Table 127:Transfer In admissions to Wollongong

Hospital by Area Health Service.................. 88

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 93

Index of Figures Figure 1:People injured, 2002-2006

(including deaths) ......................................... 7

Figure 2:Admissions to trauma centres ...................... 8

Figure 3:Admissions to Trauma Services by age and

gender ......................................................... 10

Figure 4:Mechanisms of injury ................................... 11

Figure 5:People injured by hour of day when injury

occurred ...................................................... 16

Figure 6: AIS body regions .......................................... 18

Figure 7:Low/medium falls, 2002-2006 ...................... 20

Figure 8:Low to medium fall (<5m) admissions to all

Trauma Centres by age ................................. 21

Figure 9:Low to medium fall (<5m) trauma by

hour of day that injury occurred ................... 21

Figure 10:Low to medium fall (<5m) admissions by

day of week that injury occurred .................. 22

Figure 11:Low/medium falls (<5m) by hour of day of

injury for people aged 65 years and over ...... 22

Figure 12:Low/medium falls (<5m) by day of week

for people aged 65 years and older .............. 23

Figure 13:Low/medium falls (<5m) - geographical

location of injury by Area Health Service ....... 23

Figure 14:Low to medium fall (<5m) trauma patient

admissions to all Trauma Services by age

(injuries at home) ......................................... 24

Figure 15:Low/medium fall (<5m) related admissions to

trauma centres by ISS range ......................... 24

Figure 16:AIS body regions for low/medium falls

(<5m) ........................................................... 25

Figure 17:Low/medium falls - mode of arrival .............. 26

Figure 18:Low/medium fall (<5m) related admissions to

trauma centres by admission type ................ 26

Figure 19: Times to defi nitive care, direct from scene,

within 2 hours, Low/medium falls,

MVC, MBC, Pedestrian ................................. 27

Figure 20:Low/medium falls (<5m) -

surgical procedures ...................................... 27

Figure 21:Low/medium falls (<5m) -

Intensive Care Unit admissions ..................... 28

Figure 22:Low/medium fall related admissions to

trauma centres by age and outcome ............ 28

Figure 23:Pedestrian trauma, 2002-2006 ..................... 29

Figure 24:Pedestrian trauma patient admissions to all

Trauma Centres by age range ....................... 30

Figure 25:Pedestrian trauma by hour of day

that injury occurred ...................................... 30

Figure 26:Pedestrian trauma admissions by

day of week that injury occurred .................. 31

Figure 27:Pedestrians - geographical location of

injury by Area Health Service ........................ 31

Figure 28:Pedestrian related admissions to

trauma centres by ISS range ......................... 32

Figure 29:AIS body regions for pedestrian trauma ........ 32

Figure 30:Pedestrian trauma - mode of arrival .............. 33

Figure 31:Pedestrian related admissions to

trauma centres for 2006 by admission type .. 34

Figure 32:Pedestrian trauma -

surgical procedures ...................................... 34

Figure 33:Pedestrian trauma -

intensive care admissions ............................. 35

Figure 34:Pedestrian trauma by age and outcome ....... 35

Figure 35:Trauma admissions to Gosford Hospital by

age and gender ............................................ 36

Figure 36:Trauma admissions to Gosford Hospital by

age range and outcome (%) ........................ 37

Figure 37:Trauma admissions to Gosford Hospital by

Injury Severity Score and outcome ................ 37

Figure 38:Trauma admissions to Gosford Hospital by

mechanism and outcome (%) ...................... 38

Figure 39:Trauma admissions to John Hunter Hospital /

John Hunter Children’s Hospital by age and

gender ......................................................... 40

Figure 40:Paediatric trauma admissions to John Hunter

Children’s Hospital by age and gender .......... 41

Figure 41:Trauma admissions to John Hunter Hospital /

John Hunter Children’s Hospital by age range

and outcome (%) ......................................... 41

Figure 42:Trauma admissions to John Hunter Hospital /

John Hunter Children’s Hospital by Injury

Severity Score and outcome ......................... 42

Figure 43:Trauma admissions to John Hunter Hospital /

John Hunter Children’s Hospital by mechanism

and outcome (%) ......................................... 43

Figure 44:Trauma admissions to Liverpool Hospital

by age and gender ....................................... 45

Figure 45:Trauma admissions to Liverpool Hospital

by age range and outcome (%) .................... 45

Figure 46:Trauma admissions to Liverpool Hospital

by Injury Severity Score and outcome ........... 46

94 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health

Figure 47:Trauma admissions to Liverpool Hospital

by mechanism and outcome (%) .................. 47

Figure 48:Trauma admissions to Nepean Hospital

by age and gender ....................................... 49

Figure 49:Trauma admissions to Nepean Hospital

by age range and outcome .......................... 50

Figure 50:Trauma admissions to Nepean Hospital

by Injury Severity Score and outcome ........... 50

Figure 51:Trauma admissions to Nepean Hospital

by mechanism and outcome (%) .................. 51

Figure 52:Trauma admissions to Prince of Wales Hospital

by age and gender ....................................... 53

Figure 53:Trauma admissions to Prince of Wales Hospital

by age range and outcome (%) .................... 54

Figure 54:Trauma admissions to Prince of Wales Hospital

by Injury Severity Score and outcome ........... 54

Figure 55:Trauma admissions to Prince of Wales Hospital

by mechanism and outcome (%) .................. 55

Figure 56:Trauma admissions to Royal North Shore

Hospital by age and gender .......................... 57

Figure 57:Trauma admissions to Royal North Shore

Hospital by age range and outcome (%) ...... 58

Figure 58:Trauma admissions to Royal North Shore

Hospital by Injury Severity Score

and outcome ............................................... 58

Figure 59:Trauma admissions to Royal North Shore

Hospital by mechanism and outcome (%) .... 59

Figure 60:Trauma admissions to Royal Prince Alfred

Hospital by age and gender .......................... 61

Figure 61:Trauma admissions to Royal Prince Alfred

Hospital by age range and outcome (%) ...... 62

Figure 62:Trauma admissions to Royal Prince Alfred

Hospital by Injury Severity Score

and Outcome ............................................... 62

Figure 63:Trauma admissions to Royal Prince Alfred

Hospital by mechanism and outcome (%) .... 63

Figure 64:Trauma admissions to St George Hospital

by age and gender ....................................... 65

Figure 65:Trauma admissions to St George Hospital

by age range and outcome (%) .................... 66

Figure 66:Trauma admissions to St George Hospital

by Injury Severity Score and Outcome ........... 66

Figure 67:Trauma admissions to St George Hospital

by mechanism and outcome (%) .................. 67

Figure 68:Trauma admissions to St Vincent’s Hospital

by age and gender ....................................... 69

Figure 69:Trauma admissions to St Vincent’s Hospital

by age range and outcome .......................... 70

Figure 70:Trauma admissions to St Vincent’s Hospital by

Injury Severity Score and Outcome ............... 70

Figure 71:Trauma admissions to St Vincent’s Hospital

by mechanism and outcome (%) .................. 71

Figure 72:Paediatric trauma admissions to Sydney

Children’s Hospital by age and gender .......... 73

Figure 73:Trauma admissions to Sydney Children’s

Hospital by age range and outcome (%) ...... 74

Figure 74:Trauma admissions to Sydney Children’s

Hospital by Injury Severity Score and

outcome ...................................................... 74

Figure 75: Trauma admissions to Sydney Children’s

Hospital by mechanism and outcome (%) .... 75

Figure 76:Paediatric trauma admissions to The Children’s

Hospital at Westmead for by age and

gender ......................................................... 77

Figure 77:Trauma admissions to the Children’s Hospital

at Westmead by age range and

outcome (%) ................................................ 78

Figure 78:Trauma admissions to The Children’s Hospital

at Westmead by Injury Severity Score and

Outcome ...................................................... 78

Figure 79:Trauma admissions to The Children’s Hospital

at Westmead by mechanism and

outcome (%) ................................................ 79

Figure 80:Trauma admissions to Westmead Hospital

by age and gender ....................................... 81

Figure 81:Trauma admissions to Westmead Hospital

by age range and outcome (%) .................... 82

Figure 82:Trauma admissions to Westmead Hospital

by Injury Severity Score and outcome ........... 82

Figure 83:Trauma admissions to Westmead Hospital

by mechanism and outcome (%) .................. 83

Figure 84:Trauma admissions to Wollongong Hospital

by age and gender ......................................... 85

Figure 85:Trauma admissions to Wollongong Hospital

by age range and outcome (%) .................... 86

Figure 86:Trauma admissions to Wollongong Hospital

by Injury Severity score and outcome ............ 86

Figure 87:Trauma admissions to Wollongong Hospital

by mechanism and outcome (%) .................. 87

NSW Health ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 95

Notes

96 ITIM – The NSW Trauma Registry Profi le of Serious to Critical Injuries - 2006 NSW Health


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