Trauma Registry Data

WESTMEAD HOSPITAL – DEPARTMENT OF SURGERY     TRAUMA SERVICE REGISTRY

The Westmead Hospital Trauma Registry was established in January 1985 and by now it contains data on over 62,500 patients. Information stored in the registry includes demographic information together with pre-hospital data, in hospital management, injuries, complications and discharge status.
The availability of the information relating to injury severity and outcome enables the identification of causes of the greatest degree of disability.

TRAUMA REGISTRY GOALS:

  • Performance Improvement
  • Quality Assurance
  • Public Health
  • Outcomes Research
  • Resource Utilisation

TRAUMA REGISTRY FUNCTION:

Injury Prevention: The information relating to injury severity and outcome enables identification of causes and consequences of mechanism of injury. Injury statistics are utilised by  the Injury Prevention Unit, Western Sydney Local Health District, Motor Accident Authority and NSW Health to identify trends and provide strategies for injury prevention. (ITIM)

Pre-hospital Care and Transport: With the advent of the ambulance trauma triage system it is essential that data is available regarding patient outcome to assess the efficiency, appropriateness and  promptness of pre-hospital ambulance response. This data is available to NSW Health on a regular basis to enable evaluation of the system to take place.

Early Hospital Management: The data assesses the efficiency of the in hospital trauma system from admission to rehabilitation System problems are identified and the statistics obtained can give validity to initiating change within the system.  Continuing improvements in the system can lead to minimising early and long term  disability in the injured patient.

Audit Programs: Audit programs are required to evaluate such indices as critical care indicators, trauma team response, identify system failure, specific injuries and morbidity to identify areas, which require modification and improvement.

All trauma deaths are audited and conclusions drawn from these reviews alter the management of future patients.

Research and Education: The Trauma registry is utilised in the areas of research and education to enable medical, nursing and paramedical staff to identify areas that need ongoing investigation.

The trauma population is divided into major and minor trauma. 

Definition of Major Trauma in Database– Involves the presence of at least one of the following:

Trauma deaths

  • Admission to ICU (Intensive Care Unit) and or HDU (High Dependency Unit)
  • Injury Severity Score >12 (ISS)
  • Urgent surgery for intracranial, intrathoracic, or intra-abdominal injury, or for fixation of pelvic or spinal fractures.

Definition of Minor Trauma in Database

  • All other trauma admissions to Westmead Hospital.
  • Exclusions: Drowning and ingestions/poisonings.

Definition of Injury Severity Score

The Injury Severity Score (ISS) is an anatomical scoring system that provides an overall score for patients with multiple injuries.  Each injury is assigned an Abbreviated Injury Scale (AIS) score and is allocated to one of six body regions (Head, Face, Chest, Abdomen, Extremities (including Pelvis), External).  Only the highest AIS score in each body region is used.  The 3 most severely injured body regions have their score squared and added together to produce the ISS score.

Population Demographics:

Westmead Hospital is part of the Western Sydney Local Health District and is responsible for providing primary and secondary health care for people living in the local government areas (LGAs) of Auburn, Baulkham Hills, Blacktown, Holroyd and Parramatta, and tertiary care to the entire western region for an estimated population of 1.7 million people.
Access to a comprehensive trauma registry has enhanced the multidisciplinary approach to trauma management at Westmead Hospital WSLHD.
The Trauma Service has recently developed a number  of  protocols and guidelines
To ensure that the highest standards of care are maintained in accordance with national and international guidelines.
We have over the last two years made some important advances in the management of the multiple injured.

  • Management algorithm for DVT/PE Prophylaxis
  • Cervical Spine Clearance
  • Multidisciplinary Trauma Clinic
  • World Wide Web under Trauma.org
  • Trauma Office library
  • Revision of the Trauma Call Criteria
  • Emergency Trauma Code for the exsanguinating patient
  • Weekly trauma education meetings
  • Annual Austrauma Trauma Conference
  • Trauma Ultrasound Course
  • Revision and update of the Westmead Trauma Manual (2002, 3rd edition)
  • Dedicated trauma research committee
  • Trauma centre verification project
  • Consultant Trauma Team Leader roster

We have made a very serious commitment to advancing trauma care in both Westmead and the Sydney Western Area and we will continue to make this an oustanding Area Health Service, which leads by example.

File_Pdf 2009_The_NSW_Trauma_Registry_Profilious_to_Critical_Injuries_2009_38