A decade of Intensive Care Unit trauma admissions in Auckland

Aims. To describe the demographics, nature and severity of injury of trauma admissions to a New Zealand urban Intensive Care Unit (ICU) over a ten yea r period; to determine differences in injury characteristics between patien ts received from inside and outside the local trauma catchment area; and to calculate incidence rates in the local population served, to identify high risk groups of patients. Methods. We carried out a cross-sectional analysis of a prospective ICU pat ient registry. Data on all trauma admissions from 1988 to 1997 to the ICU o f a large New Zealand urban hospital were studied with respect to age, gend er, ethnicity, injury type and severity, and referral status. National Cens us data for the ICU catchment area were used to calculate incidence rates f or local admissions. Results. A total of 2305 trauma patients were admitted over the period of t he study, accounting for 25% of all ICU admissions. The median age was 28 y ears and 75% were males. Blunt trauma, mostly due to motor vehicle crashes, accounted for 95% of admissions and penetrating trauma was very rare. The median Injury Severity Score (ISS) was 26 and most life threatening injurie s occurred in. the head region. Referred admissions were more severely inju red and had a higher prevalence of severe head injury than local admissions . The ICU trauma admission rate for local patients was 34.6 per 100 000 per son-years. Males had a higher rate than, females in all age groups. New Zea land Europeans made up the majority of admissions, but Maori and Pacific Is land males had the highest incidence rates. Conclusions. This study identified trauma as a major component of the ICU p opulation. ICU trauma admissions were characterised by young males with hea d injuries resulting from motor vehicle crashes. Referred admissions were m ore severely injured than local admissions and would thus distort the estim ated incidence of trauma in the local geographic region served. Calculation of incidence rates highlighted a significantly higher risk of ICU trauma a dmission amongst Maori and Pacific Islands people than New Zealand European s.