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Article: The first 5 years since Trauma Center Designation in the Hong Kong Special Administrative Region, People's Republic of China

TitleThe first 5 years since Trauma Center Designation in the Hong Kong Special Administrative Region, People's Republic of China
Authors
KeywordsChina
Hong Kong
Injury
Outcome
Trauma system
TRISS
Issue Date2011
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.jtrauma.com
Citation
Journal Of Trauma - Injury, Infection And Critical Care, 2011, v. 70 n. 5, p. 1128-1133 How to Cite?
AbstractBackground: In 1994, the Hong Kong Special Administrative Region (HKSAR) introduced plans to implement a trauma system based on the recommendations outlined by Professor Donald Trunkey in his report to the local Hospital Authority. Five government-subsidized public hospitals were subsequently designated as trauma centers in 2003. This article reviews the initial experience in these five centers. Methods: Prospective trauma registries from January 2004 to December 2008 were reviewed. Primary clinical outcome measures were hospital mortality. The Trauma and Injury Severity Score methodology was used for benchmarking with the Major Trauma Outcome Study (MTOS) database. Results: The majority (83.3%) of the 10,462 patients suffered from blunt trauma. Severe injury, defined as Injury Severity Score >15, occurred in 29.7% of patients. The leading causes of trauma were motor vehicle collisions and falls, with crude hospital mortality rates of 6.9% and 10.7%, respectively. The M-statistic was 0.95, indicating comparable case-mix with the MTOS. The worst outcome occurred in the first year. Significant improvement was seen in patients with penetrating injuries. By 2008, these patients had significantly higher survival rates than expected (Z-statistic = 0.85). Although the overall mortality rates for blunt trauma were higher than expected, the difference was no longer statistically significant from the second year onward. 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. Copyright © 2011 by Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/134479
ISSN
2013 Impact Factor: 2.961
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLeung, GKKen_HK
dc.contributor.authorChang, Aen_HK
dc.contributor.authorCheung, FCen_HK
dc.contributor.authorHo, HFen_HK
dc.contributor.authorHo, Wen_HK
dc.contributor.authorHui, SMen_HK
dc.contributor.authorKam, CWen_HK
dc.contributor.authorLai, Aen_HK
dc.contributor.authorLam, KWen_HK
dc.contributor.authorLeung, Men_HK
dc.contributor.authorLiu, SHen_HK
dc.contributor.authorLo, CBen_HK
dc.contributor.authorMok, Fen_HK
dc.contributor.authorRainer, THen_HK
dc.contributor.authorShen, WYen_HK
dc.contributor.authorSo, FLen_HK
dc.contributor.authorWong, Gen_HK
dc.contributor.authorWu, Aen_HK
dc.contributor.authorYeung, Jen_HK
dc.contributor.authorYuen, WKen_HK
dc.date.accessioned2011-06-17T09:21:41Z-
dc.date.available2011-06-17T09:21:41Z-
dc.date.issued2011en_HK
dc.identifier.citationJournal Of Trauma - Injury, Infection And Critical Care, 2011, v. 70 n. 5, p. 1128-1133en_HK
dc.identifier.issn0022-5282en_HK
dc.identifier.urihttp://hdl.handle.net/10722/134479-
dc.description.abstractBackground: In 1994, the Hong Kong Special Administrative Region (HKSAR) introduced plans to implement a trauma system based on the recommendations outlined by Professor Donald Trunkey in his report to the local Hospital Authority. Five government-subsidized public hospitals were subsequently designated as trauma centers in 2003. This article reviews the initial experience in these five centers. Methods: Prospective trauma registries from January 2004 to December 2008 were reviewed. Primary clinical outcome measures were hospital mortality. The Trauma and Injury Severity Score methodology was used for benchmarking with the Major Trauma Outcome Study (MTOS) database. Results: The majority (83.3%) of the 10,462 patients suffered from blunt trauma. Severe injury, defined as Injury Severity Score >15, occurred in 29.7% of patients. The leading causes of trauma were motor vehicle collisions and falls, with crude hospital mortality rates of 6.9% and 10.7%, respectively. The M-statistic was 0.95, indicating comparable case-mix with the MTOS. The worst outcome occurred in the first year. Significant improvement was seen in patients with penetrating injuries. By 2008, these patients had significantly higher survival rates than expected (Z-statistic = 0.85). Although the overall mortality rates for blunt trauma were higher than expected, the difference was no longer statistically significant from the second year onward. 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. Copyright © 2011 by Lippincott Williams & Wilkins.en_HK
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.jtrauma.comen_HK
dc.relation.ispartofJournal of Trauma - Injury, Infection and Critical Careen_HK
dc.subjectChinaen_HK
dc.subjectHong Kongen_HK
dc.subjectInjuryen_HK
dc.subjectOutcomeen_HK
dc.subjectTrauma systemen_HK
dc.subjectTRISSen_HK
dc.subject.meshHealth Planning-
dc.subject.meshHong Kong - epidemiology-
dc.subject.meshRegistries - statistics and numerical data-
dc.subject.meshTrauma Centers - organization and administration-
dc.subject.meshWounds, Nonpenetrating - diagnosis - epidemiology - therapy-
dc.titleThe first 5 years since Trauma Center Designation in the Hong Kong Special Administrative Region, People's Republic of Chinaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0022-5282&volume=70&issue=5&spage=1128&epage=1133&date=2011&atitle=The+first+5+years+since+trauma+center+designation+in+the+Hong+Kong+Special+Administrative+Region,+People%27s+Republic+of+China-
dc.identifier.emailLeung, GKK: gilberto@hkucc.hku.hken_HK
dc.identifier.authorityLeung, GKK=rp00522en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/TA.0b013e3181fd5d62en_HK
dc.identifier.pmid21336195-
dc.identifier.scopuseid_2-s2.0-79955779158en_HK
dc.identifier.hkuros185783en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79955779158&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume70en_HK
dc.identifier.issue5en_HK
dc.identifier.spage1128en_HK
dc.identifier.epage1133en_HK
dc.identifier.eissn1529-8809-
dc.identifier.isiWOS:000290480300032-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLeung, GKK=35965118200en_HK
dc.identifier.scopusauthoridChang, A=14035288100en_HK
dc.identifier.scopusauthoridCheung, FC=47160889600en_HK
dc.identifier.scopusauthoridHo, HF=36096620700en_HK
dc.identifier.scopusauthoridHo, W=36855639600en_HK
dc.identifier.scopusauthoridHui, SM=47161107100en_HK
dc.identifier.scopusauthoridKam, CW=7102416674en_HK
dc.identifier.scopusauthoridLai, A=47161347000en_HK
dc.identifier.scopusauthoridLam, KW=47161300000en_HK
dc.identifier.scopusauthoridLeung, M=55202734700en_HK
dc.identifier.scopusauthoridLiu, SH=24171816800en_HK
dc.identifier.scopusauthoridLo, CB=47161303500en_HK
dc.identifier.scopusauthoridMok, F=12800551300en_HK
dc.identifier.scopusauthoridRainer, TH=7004489495en_HK
dc.identifier.scopusauthoridShen, WY=47161463100en_HK
dc.identifier.scopusauthoridSo, FL=7003481644en_HK
dc.identifier.scopusauthoridWong, G=47161634800en_HK
dc.identifier.scopusauthoridWu, A=47161767300en_HK
dc.identifier.scopusauthoridYeung, J=11141557600en_HK
dc.identifier.scopusauthoridYuen, WK=7102761292en_HK

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