The New Zealand medical journal
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Multicenter Study Comparative Study
Contemporary New Zealand coefficients for the Trauma Injury Severity Score: TRISS(NZ).
To develop local contemporary coefficients for the Trauma Injury Severity Score in New Zealand, TRISS(NZ), and to evaluate their performance at predicting survival against the original TRISS coefficients. ⋯ Both TRISS models accurately predicted survival for blunt mechanism trauma. However, TRISS(NZ) coefficients were statistically superior to TRISS coefficients. A strong case exists for replacing TRISS coefficients in the New Zealand benchmarking software with these updated TRISS(NZ) estimates.
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Primary: To ascertain how many New Zealand (NZ) children are being injured or killed as the result of all-terrain vehicle (ATV) injuries and to define the nature and severity of their injuries. Secondary: to examine the effect of age, weight, helmet use, and ATV size on injury severity and to compare the demographics of injury in NZ to other countries. ⋯ ATVs are potentially lethal and have the capacity to inflict significant harm.. It is clear that it is not appropriate for a young child to ride an adult sized ATV due to the risk of serious injury and death. Public debate is needed as to whether education or legislation is the answer.
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Comparative Study
Time to definitive care for patients with moderate and severe traumatic brain injury--does a trauma system matter?
The presence of a trauma system has been associated with improved outcomes in patients with traumatic brain injury (TBI) by speeding up transfers to a neurosurgical centre. Improved outcomes are associated with time to neurosurgical intervention for those with significant extradural and subdural haemorrhages of less than 4 hours. To compare the outcomes for patients with TBI transferred directly from the scene of injury to Auckland City Hospital (ACH) with those transferred from other hospitals, transfer times and outcomes were evaluated in a consecutive cohort of patients recorded on the ACH trauma registry. ⋯ TBI patients who were transferred from another hospital arrived well outside the recommended guidelines. While no significant difference in outcome was noted in this small cohort of patients further studies are warranted. The development of a national trauma registry would allow accumulation of data on larger numbers of patients and determine the true relevance of international best practice guidelines in New Zealand.
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Multicenter Study Comparative Study
Emergency Department utilisation: a natural experiment.
In February 2005 a new Emergency Department (ED) was opened at Waitakere Hospital in West Auckland, New Zealand. Part of the rationale for this was the expectation that it would reduce attendances to the four established EDs in the Auckland region. This study was undertaken to determine whether this happened. ⋯ The opening of a new ED may have contributed to an increase in total ED presentations seen within the region overall, with no corresponding reduction in attendances at neighbouring hospitals.