Sydney Medical School, University of Sydney, Sydney, NSW
Sydney Nursing School, University of Sydney, Sydney, NSW.
Med J Aust. 2016 Nov 7;205(9):403-407. doi: 10.5694/mja16.00406.
To determine trends in crude and risk-adjusted mortality for major trauma patients injured in rural or metropolitan New South Wales, 2009-2014.
A retrospective analysis of NSW statewide trauma registry data.
Adult patients (aged 16 years or more) who presented with major trauma (Injury Severity Scores greater than 15) to a NSW hospital during 2009-2014.
The main covariate of interest was geographic location of injury (metropolitan v rural/regional areas). Inpatient mortality was analysed by multivariable logistic regression.
Data for 11 423 eligible patients were analysed. Inpatient mortality for those injured in metropolitan locations was 14.7% in 2009 and 16.1% in 2014 (P = 0.45). In rural locations, there was a statistically significant decline in in-hospital mortality over the study period, from 12.1% in 2009 to 8.7% in 2014 (P = 0.004). Risk-adjusted mortality for those injured in a rural location was lower in 2013 than during 2009, but remained stable for those injured in metropolitan locations.
Crude and risk-adjusted mortality after major trauma have remained stable in those injured in metropolitan areas of NSW between 2009 and 2014. The apparent downward trend in mortality associated with severe trauma in rural/regional locations requires further analysis.
确定 2009-2014 年新南威尔士州农村或城市地区严重创伤患者的粗死亡率和风险调整死亡率趋势。
对新南威尔士州全州创伤登记数据的回顾性分析。
2009-2014 年期间在新南威尔士州医院就诊的患有严重创伤（损伤严重程度评分大于 15）的成年患者（16 岁及以上）。
主要的感兴趣协变量是受伤的地理位置（城市与农村/地区）。通过多变量逻辑回归分析住院死亡率。
分析了 11423 名符合条件的患者的数据。2009 年和 2014 年，在城市地区受伤的患者住院死亡率分别为 14.7%和 16.1%（P=0.45）。在农村地区，研究期间住院死亡率呈统计学显著下降，从 2009 年的 12.1%降至 2014 年的 8.7%（P=0.004）。2013 年农村地区受伤者的风险调整死亡率低于 2009 年，但城市地区受伤者的死亡率保持稳定。
2009 年至 2014 年期间，新南威尔士州城市地区严重创伤患者的粗死亡率和风险调整死亡率保持稳定。与农村/地区严重创伤相关的死亡率下降趋势需要进一步分析。
