Review of Major Trauma Networks reveals increase in patient survival rates
Results from the national audit by the Trauma Audit and Research Network (TARN) released today show that an increasing number of patients who would have died before the introduction of trauma networks in England, now survive severe injuries.
Maralyn Woodford is Director of TARN. She is also part of the Institute of Population Health at The University of Manchester and based at Salford Royal NHS Foundation Trust. She said the data collected helps hospitals to evaluate their trauma services and review how they rate in comparison with other Trusts.
"TARN was founded in 1989 when research showed that there were preventable trauma deaths in the UK,” she said. “There have been many changes in the NHS since 1989 – and our data collection continues to enable clinicians and managers to review their trauma care and make changes if required.”
The main change in trauma care has been the introduction of Regional Trauma Networks in 2012 to enable the rapid and safe transfer of patients to designated Major Trauma Centres throughout the country. The networks were developed by doctors, nurses and allied health professionals including paramedics and physiotherapists, to ensure that the patient receives the best possible care from the scene of the accident through to their rehabilitation at home.
Professor Tim Coats, Chairman of TARN and Professor of Emergency Medicine at the University of Leicester, said: “The injured are now treated by the right clinicians, in the right hospitals, as quickly as possible. Our patients now receive much more rapid care from specialist trauma teams who can identify life-threatening injuries much quicker, access key tests such as CT scans faster and perform life-saving operations earlier.”
The TARN interrupted casemix adjusted time series analysis suggests that the odds of a major trauma patient surviving in NHS England are 63% better in 2014/15 than in 2008/09, with a statistically significant seven-year improvement trend. Prior to the introduction of the new trauma networks (2008/09 -2011/12) there had been no significant trend for improved odds of survival.
Professor Fiona Lecky, TARN Research Director and Professor of Emergency Medicine at the University of Sheffield, said: “Data quality from some trauma receiving hospitals was inconsistent over the time period of this analysis, therefore this result is based on a subset of English hospitals rather than all hospitals involved in trauma care. Whilst it is clear that we have more work to do in improving data quality, there has certainly been some improvement in the care of the injured since 2011/12.”
As well as improving survival, a key aim of the Major Trauma Networks is to improve the quality of life in the survivors. In collaboration with a number of Major Trauma Centres, TARN is assessing the feasibility of routine collection of patient reported outcomes to plan future services based on the long term impact of major trauma on patients.