• Alan A Garner, Leela Sai Krishna Suryadevara, Charlie Sewalt, Stuart Lane, and Rajneesh Kaur.
• Trauma Department, Nepean Hospital, Derby St, Kingswood NSW 2747, Australia; University of Sydney, Nepean Clinical School, Australia. Electronic address: alan.garner@sydney.edu.au.
• Injury. 2024 May 1; 55 (5): 111506111506.

IntroductionConventional wisdom is that Major Trauma Services (MTS) treating larger volumes of severe trauma patients will have better outcomes than lower volume centres, but recent studies from Europe have questioned this relationship. We aimed to determine if there is a relationship between patient volume and outcome in New South Wales (NSW) MTS hospitals.Materials And MethodsRetrospective observational study using data from the NSW State Trauma Registry from 2010 to 2019 inclusive. Adult patients with Injury Severity Score >15 transported directly to a NSW MTS were included. Outcome measures were mortality at hospital discharge, and intensive care unit and hospital length of stay. Generalised estimating equation models were created to determine the adjusted relationship between patient volume and the main outcome measures.ResultsThe mean annual patient volume of the MTS ranged from 127.4 to 282.0 patients whilst the observed mortality rates p.a. ranged from 10.4 % to 17.19 %. Multivariate analysis, using low volume MTS as the reference, did not demonstrate a significant difference in mortality between high and low volume MTS (adjusted OR: 1.14 95 % CI: 0.98-1.25, P = 0.087). There was however a significant correlation between volume and length of hospital stay (adjusted β; 0.024, 95 % CI, 0.182 - 1.089, P = 0.006).ConclusionsThere was no mortality difference between high and low volume MTS demonstrated. Length of hospital stay significantly increased with increasing volume however.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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