Major trauma networks (England)

Changing the System - Major Trauma Patients and Their Outcomes in the NHS (England) 2008-17.

Moran CG, Lecky F, Bouamra O, et al. EClinicalMedicine 2018 · PMID 31193723 · doi:10.1016/j.eclinm.2018.07.001

Question

Did the 2012 reorganisation of English trauma care into regional major trauma networks improve patient outcomes?

Design

Observational study of Trauma Audit and Research Network (TARN) registry data from 2008 to 2017.

Patients

Patients with major trauma treated in English hospitals over the decade spanning the introduction of trauma networks.

Intervention

Regional major trauma networks with designated major trauma centres

Comparison

Pre-network trauma care

Primary outcome

Risk-adjusted survival and process measures

Key result

After network implementation there were improvements in risk-adjusted odds of survival, faster senior care and CT, and more patients treated in major trauma centres.

Limitations

Before-and-after registry design cannot separate the effect of networks from secular trends, and data capture improved over the period.

Impact on practice

Provides key evidence supporting the regional trauma network model, with direct triage of severely injured patients to major trauma centres.