More than 1,600 additional trauma victims live today, report finds

The NHS in England has saved 1,600 patients with serious injuries since a series of large trauma centers was set up six years ago.

The 27 designated large trauma centers have been operating since April 2012 and play a vital role in rescuing the victims of mes-, pistol- and acid attack crimes.

They see severely injured patients directly to the designated large trauma centers, beyond smaller, local hospitals offering less specialist care.

An independent report, which can be seen in the latest issue of EClinical Medicine, published by The Lancet, shows that patients also spent fewer days in the hospital and improved their quality of life after receiving critical care.

The analysis of more than 110,000 patients admitted to 35 hospitals between 2008 and 2017 shows an increase of almost one fifth of the chances of survival of severe damage in the five years from 2012.

Researchers calculated that there were 595 additional survivors in 2017 – five years after the start of the new system – so they are ahead of the target for the final 450 to 600 additional survivors that NHS England predicted when the reorganization was announced, as it Five and ten years take years to allow a trauma system to mature and reach its full potential.

The report is compiled by the Trauma Audit and Research Network (TARN), based at the University of Manchester and supported by experts from the universities of Leicester and Sheffield.

Timothy Coats, professor of emergency medicine at the University of Leicester and consultant in emergency medicine at Leicester hospitals, described the new system as a "fantastic achievement".

He said: "These findings demonstrate and support the importance of large trauma networks for emergency care with figures that show that in 2013 there were still 90 survivors reaching an extra 595 in 2017.

"Over the course of five years, 1,656 people have survived major trauma injuries, where they would probably have died earlier.

"It also shows that with changes in the way patients are treated from the moment that doctors and paramedics arrive at them, with intubation in front of the hospital, improved treatment for major bleeding and advancement in surgical emergency techniques, there is also a significant reduction of 31% to 24% of the number of patients needing critical care, and the duration of their stay in intensive care units are reduced on average from four to three days. "

Trauma remains the most common cause of death among people under 40 in England, with survivors often being long-term disabled.

The National Audit Office (NAO) estimates that there are 20,000 serious trauma cases per year, with 5,400 deaths.

NHS England's medical director for acute care, Professor Keith Willett, who led the changes in 2012 and is now leading the broader NHS emergency and emergency response, said: "We have made significant advances in emergency care over the past five years, since this study shows.

"As the NHS develops its 10-year plan, the success of major trauma centers will help to inform how we provide better patient care through the use of specialized clinical networks."

Professor Chris Moran, National Clinic Director of NHS England for trauma care, said: "This study shows that changes in trauma care, designed by doctors, save hundreds of lives every year.

"Patients who have been seriously injured must go to the appropriate specialized center where experts are located, not just the nearest hospital.

"Thanks to the skills of NHS employees, we are confident that we will continue to see further increases in survival rates for this group of patients.

"Large trauma centers have to deal with the victims of stabbing and acid attacks, but also with car and motorcycle accidents.

"We have all seen the terrible increase in crime in our cities, especially in London, and there is no doubt that the new trauma system has saved many lives because these patients receive blood transfusion and specialist surgery much faster than before.

"The whole system, from pre-hospital care to recovery and rehabilitation, has improved."

The NAO has recommended setting up a network of trauma centers in 2010 in a devastating report, which describes how traffic accidents, strikes and shooting accidents were "unacceptable" variations in care, depending on the hospital where they were taken.

It suggested that between 450 and 600 lives per year could be saved by improving the management of trauma cases.

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