Risk of death among cases attending South Australian major trauma services after severe trauma: The first 4 years of operation of a state trauma system

Background: Factors predictive of death at South Australian major trauma services were investigated among 8,654 patients who had experienced severe trauma from 1997 to 2000. Method. Univariate and multivariate analyses of age, sex, injury severity, presence of comorbid conditions, and calendar year of presentation were performed. Results. Multiple logistic regression indicated that factors predictive of death were older age; higher injury severity as indicated by the New Injury Severity Score and the Revised Trauma Score; and accompanying chronic liver disease, ischemic heart disease, and chronic renal failure. A decrease in risk of death by calendar year was statistically significant (p=0.001). Using 1997 as the reference, the relative odds of death were 0.86 (95% confidence limits) (0.53, 1.39) for 1998, 0.60 (0.36, 0.99) for 1999, and 0.45 (0.27, 0.76) for 2000. Conclusion: Results show a decrease in risk of death of patients attending South Australian major trauma services, from injuries of equivalent severity, during the first 4 years of operation of the State Trauma System.