Paediatric and adolescent trauma care within an integrated trauma system

Background: The aim of this study was to establish the profile and outcomes of paediatric major trauma care (PTMC) within an integrated inclusive regionalised trauma system. Methods: Prospectively collected data from July 2001 to June 2009 from the Victorian State Trauma Registry of patients aged 2) was the most frequent injury (n = 950, 58 ). Surgery was required in 39 (n = 637) of all cases; 437 patients in the 10-17 year old group and 200 patients in the 0-9 year old group; the mortality was 6.6 . There were 530 patients (32.4 ) ventilated in ICU; these had a median ISS (IQR) of 25 (17-34) and mortality of 7.4 . Improvements in risk-adjusted mortality have occurred as the years have progressed [adjusted OR 95 CI: 0.87 (0.76, 0.99)] and being treated at a Level 1 trauma centre was associated with lower adjusted odds of mortality [adjusted OR 95 CI: 0.27 (0.11, 0.68)]. Conclusion: The establishment of this integrated inclusive regionalised trauma system has been associated with progressively improving risk-adjusted mortality. The relatively low volume of major trauma requiring surgery in the 0-9 year old age group is notable, creating a challenging environment for maintaining skills and institutional preparedness