Clin Exp Emerg Med.  2019 Dec;6(4):321-329. 10.15441/ceem.18.088.

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

Affiliations
  • 1Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
  • 2Department of Emergency Medicine, Wonkwang University School of Medicine, Iksan, Korea. great@wku.ac.kr
  • 3Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Emergency Medical System, Graduate School of Kokushikan University, Tokyo, Japan.
  • 5Acute and Emergency Care Center, Khoo Teck Paut Hospital, Singapore.
  • 6Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
  • 7Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan.
  • 8Department of Traumatology and Critical Care, National Taiwan University Hospital, Taipei, Taiwan.
  • 9Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan.
  • 10Emergency and Trauma Department, Sungai Buloh Hospital, Selangor, Malaysia.
  • 11Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • 12Department of Emergency Medicine, UC Davis Medical Center (JFH), Sacramento, CA, USA.
  • 13Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Korea.
  • 14Department of Emergency Medicine, Hallym University Dongtan Sacred Hospital, Hallym University College of Medicine, Dongtan, Korea.

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.

Keyword

Trauma; Asian continental ancestry group; Epidemiology
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