Experts at Morriston Hospital in Swansea have formed a new partnership with colleagues in New Zealand as part of research aimed at reducing the number of deaths from chest injuries.

The partnership is being led by Morriston Hospital’s Dr Ceri Battle and is part of the hospital’s academic emergency medicine research programme. Morriston Hospital is part of Abertawe Bro Morgannwg University Health Board, who reported on the story.

Several UK hospitals are already taking part in a feasibility study in readiness for a large scale trial. Now four hospitals in New Zealand have signed up for the study. It focuses on patients with chest injuries which, while being relatively minor, can lead to serious, potentially fatal complications. Often these complications do not emerge for several days, leading to people returning to hospital as emergency cases.

The research at Morriston Hospital resulted in the creation of a risk factor-based diagnostic tool that can identify from the start which patients are most at risk of developing complications.

Consultant physiotherapist Dr Ceri Battle, who leads the epidemiology division of the academic emergency medicine research programme, said “We worked out the risk factors that are important for developing complications. These are age, the number of rib fractures, whether the patient has chronic lung disease, whether their oxygen saturations are low when they come in and whether they’re on anticoagulants. They get scored on these risk factors and the score tells you where the patient should go – home, to the ward, or to ITU.”

The risk score was fully developed and validated in a large UK-wide study. A large scale trial involving thousands of patients will now be required to test whether the screening tool works in clinical practice. Ceri Battle has worked on the project for ten years, and the early stages in Morriston Hospital eventually developed into her PhD project. Last year she secured a £230,000 Research for Patient and Public Benefit Grant from Health Research Wales for a feasibility study, called STUMBL. This is effectively a scaled down version of the forthcoming larger trial, STUMBL 2.

STUMBL started earlier this year and involved around two hundred patients from hospitals in Salford, Manchester, Taunton and Newport. The link with New Zealand was established by Professor Adrian Evans, who heads the Morriston academic emergency medicine research programme, while he was on a lecture tour there. The hospitals which have joined the trial are located in Auckland, Christchurch, Tauranga and Whakatane.

Ceri Battle said “We know the risk score works in the UK but we haven’t validated it yet overseas. The sites in New Zealand are going to validate the score for us. Then, once we have progressed to STUMBL 2, the NZ centres will participate in that so it will be an international collaboration. But there is no point us testing the tool in NZ until we know it is valid for use there.”

The results of STUMBL are expected next year. Ceri Battle said STUMBL 2 would involve up to twenty UK sites, along with those in New Zealand. Subject to a successful grant application it could start in 2019.

Adrian Evans said the hospitals in New Zealand had been very keen to become involved with the trial. He said “Their demographics are very similar to ours, as is their healthcare service. They were very impressed with the work done so far and they really want to develop their research potential as well. They have quite a large research network and are very keen to link in with ours. So this is now a truly international collaboration – the first of many between us and New Zealand.”