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Research Article: Cohort profile: The Trauma Outcomes Project, a prospective study of New Zealanders experiencing major trauma

Date Published: 2023-11-27

Abstract:
Purpose Patient-reported outcome measures (PROMs) are useful for trauma registries interested in monitoring patient outcomes and trauma care quality. PROMs had not previously been collected by the New Zealand Trauma Registry (NZTR). More than 2500 New Zealanders are admitted to hospital for major trauma annually. The Trauma Outcomes Project (TOP) collected PROMs postinjury from three of New Zealand’s (NZ’s) major trauma regions. This cohort profile paper aims to provide a thorough description of preinjury and 6 month postinjury characteristics of the TOP cohort, including specifically for M?ori (Indigenous population in Aotearoa me Te Waipounamu/NZ). Participants Between July 2019 and June 2020, 2533 NZ trauma patients were admitted to one of 22 hospitals nationwide for major trauma and included on the NZTR. TOP invited trauma patients (aged ?16 years) to be interviewed from three regions; one region (Midlands) declined to participate. Interviews included questions about health-related quality of life, disability, injury recovery, healthcare access and household income adequacy. Findings to date TOP recruited 870 participants, including 119 M?ori. At 6 months postinjury, most (85%) reported that the injury still affected them, 88% reported problems with?1 of five EQ-5D-5L dimensions (eg, 75% reported problems with pain or discomfort, 71% reported problems with usual activities and 52% reported problems with mobility). Considerable disability (World Health Organization Disability Assessment Schedule, WHODAS II, score ?10) was reported by 45% of participants. The prevalence of disability among M?ori participants was 53%; for non-M?ori it was 44%. Over a quarter of participants (28%) reported trouble accessing healthcare services for their injury. Participation in paid work decreased from 63% preinjury to 45% 6 months postinjury. Future plans The 12 and 24 month postinjury data collection has recently been completed; analyses of 12 month outcomes are underway. There is potential for longer-term follow-up interviews with the existing cohort in future. TOP findings are intended to inform the National Trauma Network’s quality improvement processes. TOP will identify key aspects that aid in improving postinjury outcomes for people experiencing serious injury, including importantly for M?ori.

Introduction:
Injury is a leading cause of disability and ill health in Aotearoa me Te Waipounamu (New Zealand; NZ). 1 2 Concerningly, between 2500 and 3000 New Zealanders are admitted to hospital for major trauma annually. 3 In 2020/2021, 2533 people were admitted to a trauma hospital in NZ; the largest number recorded annually since the National Trauma Network (NTN) was established. 3 The NTN was established in 2012 to address the variation in the quality of trauma care in NZ, and was initially funded by the Ministry of…

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