In-hospital complications among trauma admissions in a health region of New Zealand

Abstract

Introduction

Trauma patients are at higher risk of complication than general acute admissions. Understanding the complications associated with trauma care can provide insights into avoidable morbidity and guide quality improvement activities. This study aims to quantify the volume and prevalence of complications affecting trauma admissions in one of the four health regions of New Zealand (NZ).

Methods

A retrospective, observational study utilised data from the Te Manawa Taki Trauma Registry (TMTTR) to identify individuals who were hospitalised in the region due to injuries from 2015 to 2023. Data from the TMTTR was linked with the New Zealand National Minimum Dataset (NMDS) that contains in-hospital complications records mapping across multiple fields, including the patient's unique identifier, facility name and admission and complication episode date field elements. This investigation focuses on the epidemiological parameters of complications in trauma admissions.

Results

During 2015–2023, a total of 3294 trauma admissions of all severities to Te Manawa Taki facilities involved one or more hospital-acquired complications, representing 6.2% of the total 52,899 admissions. The volume of complications in non-major trauma patients is 2.3 times that of major trauma. Complications were associated with increasing age, female gender and non-Māori ethnicity (p < 0.01). Acute kidney failure, urinary tract infections and pneumonia are the top three complication irrespective of severity. Admissions with complications have a significantly higher mean hospital Length Of Stay (LOS) 13.6 days compared to 3.8 days for those without complications (t = 76.6, p < 0.001).

Conclusion

Analysis of complications in trauma admissions has shown important variation in demographic characteristics and types of complications that may be amenable to mitigation and reduction of the impact on patients and the health system. This study has set the scene for further investigation into the clinical, in-hospital, socio-demographic and pre-existing health status factors that increase the risk of complications in trauma admissions.