Key messages
- The Victorian State Trauma Registry has broad-based inclusion criteria for major trauma.
- Inclusion criteria include all deaths after injury and patients admitted to an intensive care or high-dependency area for more than 24 hours.
- Exclusion criteria include specific spinal injuries, dislocations and soft tissue injuries.
To ensure the Victorian State Trauma Registry (VSTR) captures all major trauma patients in Victoria, broad-based inclusion criteria are used.
Major trauma definition
The definition of major trauma for the VSTR is adapted from the Review of Trauma and Emergency Services 1999 (ROTES) report.
The definition includes all trauma patients with injury as their principal diagnosis (irrespective of age) who meet any of the following criteria:
- death after injury
- ISS greater than 12
- admission to an intensive care unit for more than 24 hours, requiring mechanical ventilation
- urgent surgery for intracranial, intrathoracic or intraabdominal injury, or for fixation of pelvic or spinal fractures
- injury being the principal diagnosis (irrespective of age) and satisfying any of the Victorian State Trauma Registry patient inclusion criteria.
Source: Ministerial Taskforce on Trauma and Emergency Services and the Department of Human Services Working Party on Emergency and Trauma Services 1999.
Victorian State Trauma Registry patient inclusion criteria
The VSTR applies the following criteria for inclusion on the register:
- all deaths after injury
- all patients admitted to an intensive care unit or high-dependency area for more than 24 hours and mechanically ventilated after admission
- significant injury to two or more ISS body regions (an AIS of 2 or more in two or more body regions) or an ISS greater than 12
- urgent surgery for intracranial, intrathoracic or intraabdominal injury, or fixation of pelvic or spinal fractures
- electrical injuries, drowning and asphyxia patients admitted to an intensive care unit and having mechanical ventilation for longer than 24 hours or death after injury
- all patients with injury as their principal diagnosis whose length of stay is three days or more - unless they meet exclusion criteria
- all patients with injury as their principal diagnosis transferred to or received from another health service for further emergency care or admitted to a high-dependency area - unless they meet exclusion criteria.
The Victorian State Trauma Registry patient exclusion criteria
The following criteria exclude patients from the VSTR:
- isolated fractured neck of femur
- isolated upper limb joint dislocation, shoulder girdle dislocation (unless associated with vascular compromise) and toe/foot/knee joint dislocation - unless meeting inclusion criteria 1, 2 or 4
- isolated closed-limb fractures only (for example, fractured femur, Colles’ fracture) - unless meeting inclusion criteria 1, 2 or 4
- isolated injuries distal to the wrist and ankle only (for example, finger amputations) - unless meeting inclusion criteria 1, 2 or 4
- soft tissue injuries only (for example, tendon and nerve injury and uncomplicated skin injuries) - unless meeting inclusion criteria 1, 2 or 4
- burns to less than 10 per cent of the body - unless meeting inclusion criteria 1, 2 or 4
- isolated eyeball injury.
Paediatric major trauma
Major trauma patients aged 0-15 years should attend the Royal Children's Hospital. Patients aged 16 and over should attend an adult major trauma service.
As a patient's age is not always known to Ambulance Victoria, and some patients will self-present to a health service, patients may receive definitive care at the first major trauma service they attend before being transferred to an age-appropriate service when it is safe to do so.
Reviewed 30 November 2023