Traumatic Head Injury in Victoria: Rural and Urban Differences

Benjamin Fisk1, Dr Tim Baker2, Professor Sue Kilpatrick3
1 Centre for Rural Emergency Medicine, Warrnambool, Victoria, Australia & Ambulance Victoria
2 Centre for Rural Emergency Medicine, Warrnambool, Victoria, Australia
3 Deakin University, Warrnambool, Victoria, Australia

Introduction:

The majority of deaths from major trauma in Victoria continue to occur within the head injury group. Since the implementation of the Victorian State Trauma System there has been a reduction in the proportion of road trauma cases, particularly with severe head injuries, and while these results are positive there is currently a lack of research regarding rural and urban differences in traumatic head injury outcome.

Background:

There has been considerable discussion regarding the implications of major trauma in rural and remote areas of Australia, with research suggesting patients suffering traumatic injuries in rural areas have worse outcomes than those in urban areas. With one third of the Australian population residing in rural or remote locations, these communities continue to be over-represented in road transport related injury and fatality statistics.

Aims:

The aim of this study is to identify if there are differences in traumatic head injury outcomes between rural and urban areas of Victoria, and if so, to investigate the reasons for these differences.

Methods:

VSTORM data will be used to report the preliminary results of the incidence and outcomes of traumatic head injury in Victoria, using GOSE6 as the primary functional outcome measure.  Data will be categorised according to rurality using the ASGC (ARIA+) 6 point remoteness scale.

Results:

Multivariate analysis will adjust for patient variables including age, gender, co-morbidities, severity of head injury, and severity of additional injuries.  Differences in outcome will then be investigated to determine which system factors may have influenced the results.

Further Investigation:

It is planned that further investigation will explore the impact of helicopter transfers as well differences in paramedic experience on head injury outcomes in Victoria.