The case-mix of trauma patients in the HKSAR is comparable with that of the MTOS. A young trauma system relatively unburdened by dissimilar reimbursement and patient access issues may achieve significant improvement and satisfactory patient outcomes. Our findings may serve as a useful benchmark for HK and other Southeast Asian cities and trauma systems to establish local coefficients for future evaluations.
Introduction: Trauma is the commonest cause of death and major morbidities in children and adolescents worldwide. There has been a lack of data on the epidemiology of trauma among children in Chinese cities include Hong Kong. Therefore the current study was conducted to examine the spectrum of paediatric trauma in Hong Kong and to address knowledge gaps in its epidemiology and prevention. Objective: This study aimed to describe the epidemiological features of paediatric trauma and explore the characteristics in the low income group which would help to guide the design of effective interventions and future research on prevention of paediatric trauma. Method: A descriptive study on the epidemiology of trauma in children ≤18-year-old using a standardised injury registry embedded within a population-based hospital database. Information on demographics, injury type, mechanism, injury severity score (ISS) and injury prevention prioritization score (IPPZ) were collected to identify the epidemiological features and prevention initiatives. Result: The overall female to male ratio was 1: 1.97, which increased with age from 1:1.45 (infant; below 2 years old) to 1:2.67 (adolescent; 12-18 years old). The overall mean ISS was 7.98 (SD 9.18), ISS increased with age significantly (rho = 0.143, P < 0.001). The most common context of trauma included travelling (IPPZ: 59.94, mean ISS 10.2 ± 10.23, n = 402), leisure activities (IPPZ: 52.04, mean ISS 5.6 ± 6.77, n = 312), street/ highway (IPPZ: 70.22, mean ISS 10.48 ± 10.53, n = 475) and home (including garden and out buildings) (IPPZ: 69.56, mean ISS 6.64 ± 7.94, n = 539). Severity of paediatric injuries among low-income group did not differ from the general population. Conclusion: The study provided updated epidemiological characteristics of paediatric trauma, which could be used to guide focus prevention of paediatric trauma. The findings also highlighted further study initiatives including injury surveillance, geographical analysis and environment modification.
Introduction The revised trauma score (RTS) was developed more than 20 years ago. Few studies investigated its usefulness in predicting trauma outcomes. This is especially true for the weighted version of RTS (RTS-w). The aim of this study was to test the predicting power of RTS-w for the trauma outcomes including mortality, admission to intensive care unit (ICU), hospital length of stay and ICU length of stay through a comparison with Injury Severity Score (ISS). Methods Descriptive data, variables related to the trauma scores and outcomes were collected. The statistical performance of RTS-w and ISS in predicting the trauma outcomes using receiver operating characteristics (ROC) curves and the area under the curve (AUC) with 95% confidence interval and p value were calculated. The Hosmer-Lemeshow chi-squared statistic was performed to measure its calibration. Results A total of 3323 patients were enrolled in the study. RTS-w was significantly better than ISS in predicting mortality of trauma patients (AUC: 0.934 vs.0.880, p<0.0001). However, for the other three outcomes, i.e. admission to ICU, hospital length of stay and intensive care unit length of stay, the performance of RTS-w was inferior to ISS. Conclusions The RTS-w is a better predictor of mortality than ISS. But its ability to predict other trauma outcomes is not as good as ISS. More studies are needed to identify the predictive ability of RTS-w for the outcomes other than mortality. Besides, updating the coefficients of the formula may make RTS-w more accurate.
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