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Comparison of trauma systems in Asian countries: a cross-sectional study

Jung YH 1 , Wi DH 2 , Shin SD 3 , Tanaka H 4 , Shaun GE 5 , Chiang WC 6 Show all authors , Sun JT 7 , Hsu LM 8 , Kajino K 9 , Jamaluddin SF 10 , Kimura A 11 , Holmes JF 12 , Song KJ 3 , Ro YS 1 , Hong KJ 3 , Moon SW 13 , Park JO 14 , Kim MJ 1

Affiliations 

  • 1 Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
  • 2 Department of Emergency Medicine, Wonkwang University School of Medicine, Iksan, Korea
  • 3 Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  • 4 Department of Emergency Medical System, Graduate School of Kokushikan University, Tokyo, Japan
  • 5 Acute and Emergency Care Center, Khoo Teck Paut Hospital, Singapore
  • 6 Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
  • 7 Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan
  • 8 Department of Traumatology and Critical Care, National Taiwan University Hospital, Taipei, Taiwan
  • 9 Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan
  • 10 Emergency and Trauma Department, Sungai Buloh Hospital, Selangor, Malaysia
  • 11 Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
  • 12 Department of Emergency Medicine, UC Davis Medical Center (JFH), Sacramento, CA, USA
  • 13 Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Korea
  • 14 Department of Emergency Medicine, Hallym University Dongtan Sacred Hospital, Hallym University College of Medicine, Dongtan, Korea
Clin Exp Emerg Med, 2019 Dec;6(4):321-329.
PMID: 31910503 DOI: 10.15441/ceem.18.088

Abstract

OBJECTIVE: This study aimed to compare the demographic characteristics and trauma service structures and processes of hospitals in 15 countries across the Asia Pacific, and to provide baseline data for the integrated trauma database: the Pan-Asian Trauma Outcomes Study (PATOS).

METHODS: Medical directors and emergency physicians at PATOS-participating hospitals in countries across the Asia Pacific were surveyed through a standardized questionnaire. General information, trauma care system data, and trauma emergency department (ED) outcomes at each hospital were collected by email and analyzed using descriptive statistics.

RESULTS: Survey data from 35 hospitals across 15 countries were collected from archived data between June 2014 and July 2015. Designated trauma centers were identified as the highest hospital level for trauma patients in 70% of surveyed countries. Half of the hospitals surveyed had special teams for trauma care, and almost all prepared activation protocol documents for these teams. Most hospitals offered specialized trauma education programs, and 72.7% of hospitals had a hospital-based trauma registry. The total number of trauma patients visiting the ED across 25 of the hospitals was 300,376. The overall survival-to-discharge rate was 97.2%; however, it varied greatly between 85.1% and 99.7%. The difference between survival-to-discharge rates of moderate and severe injury groups was highest in Taiwan (41.8%) and lowest in Thailand (18.6%).

CONCLUSION: Trauma care systems and ED outcomes vary widely among surveyed hospitals and countries. This information is useful to build further detailed, systematic platforms for trauma surveillance and evidence-based trauma care policies.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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