PURPOSETo evaluate the performance of a prehospital trauma diversion system in Hong Kong, China.

METHODSA retrospective analysis of prospectively collected data in the trauma registry of Queen Mary Hospital, Hong Kong from 1 January 2009 to 31 December 2013 was done. All adult patients aged 18 years or above, either primarily or secondarily diverted to Queen Mary Hospital according to the trauma patient diversion protocol, were recruited. Need for trauma center level of care was based on a consensus-based criterion standard published in 2014. Performance of the protocol in terms of over- diversion and under-diversion was determined.

RESULTSA total of 209 patients were included for analysis. About 30% of the patients required trauma center level of care. The most common reason was the need for vascular, neurologic, abdominal, thoracic, pelvic, spine or limb-conserving surgery within 24 h of presentation. The over-diversion rate and under- diversion rate were 69.6% and 19.7% respectively.

CONCLUSIONThe trauma patient diversion protocol currently in use in Hong Kong is not accurate enough. Further revision and refinement is needed.

Adult ; Aged ; Aged, 80 and over ; Emergency Medical Services ; Female ; Hong Kong ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Trauma Centers

BACKGROUND: The epidemiological data on elderly patients attending Accident and Emergency Departments (AEDs) in Hong Kong is lacking. The study aimed to examine the epidemiology of geriatric patient visits to AEDs in Hong Kong, including demographic data and predictors of life-saving interventions (LSI) and admission. METHODS: A retrospective cross-sectional study of geriatric patients older than 64 years old attending three AEDs during the year 2012, with a sample of 1200 patient visits recruited. The data were retrieved from the medical records of the respective hospitals. Descriptive characteristics of the visits were provided. Multivariate logistic regression was performed to evaluate the predictors of LSI and hospital admission. RESULTS: The mean age of the patients was 79.1 years. Totally 49.7％ of the patients were male. "Diseases of the respiratory system" was the commonest diagnosis in AEDs as well as that required admission. The admission rate was 56.8％. Logistic regression demonstrated that dependent activity of daily living (ADL), arrival by ambulance, and the higher number of co-morbidities were predictors of LSI, while advanced age, dependent ADL, institutionalized patients, arrival by ambulance, and higher number of co-morbidities were predictors of hospital admission. CONCLUSIONS: Ageing population is creating an imminent burden on the emergency service in Hong Kong. Previously unavailable epidemiological information about geriatric attendance to AEDs was described. This forms the basis for development of future studies concerning the medical services on this specific group of patients.