Wisconsin — Targeted Issue

Author(s)/Presenter(s)

Guice KS, Cassidy L, Mann NC

Abstract/Description

Background: This study was undertaken to assess the current status of statewide trauma registries to facilitate a design and plans for a National Trauma Registry for Children.

Methods: A telephone survey was administered to state EMS or state trauma registry managers. Summary data for each state was compiled and state EMS or trauma registry managers reviewed the information for accuracy. Survey findings were compared with findings from a similar survey conducted in 1992.

Results: Thirty-two states reported an active state trauma registry, an increase of seven states since 1992. Thirteen additional states and the District of Columbia are discussing or planning the development of a state trauma registry. One state had a registry but hospitals were not submitting data at the time of this survey. Only four states have no plans to develop a trauma registry. Twenty-nine states with registries require all hospitals to submit data; 15 of these obtain data from trauma centers only. The most commonly reported uses for trauma registry data include advocacy, injury surveillance, education and training, and research. The least commonly reported use is for reimbursement analysis.

Conclusion: Since 1992, progress has been made in developing state trauma registries. Although the concept of a national trauma registry data collection based upon 45 existing state registries, as well as from the District of Columbia, is appealing, concerns about data comparability require resolution. Furthermore, additional work would be required to create a representative sample from which national estimates of injury or outcome could be based.

Author(s)/Presenter(s)

Guice KS, Cassidy LD, Oldham KT

Abstract/Description

Before beginning a study of trauma care for children, it is necessary to understand contemporary injury patterns of children, specifically the volume and types of injury, injury severity, and institutions where children are hospitalized for trauma. This article was designed to address these issues using the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) 2003 that contains over 7 million discharge records from hospitalized children in the United States. Our classification of hospitals into pediatric experience and trauma experience are a first step in better defining what hospital characteristics are important to the optimal care of an injured child. In an era of limited resources, we would like to assure that the right child received the right treatment at the right place.

Author(s)/Presenter(s)

Mann NC, Guice K, Cassidy L, Wright D, Koury J

Abstract/Description

Background: Statewide trauma registries have proliferated in the last decade, suggesting that information could be aggregated to provide an accurate depiction of serious injury in the United States.

Objectives: To determine whether variability exists in the composition and content of statewide trauma registries, specifically addressing case-acquisition, case-definition (inclusion criteria), and registry-coding conventions.

Methods: A cross-sectional, two-part survey was administered to managers of all statewide trauma registries. State trauma registrars also provided inclusion and exclusion criteria from their state registry and abstracted a clinical vignette designed to identify coding inconsistencies.

Results: Thirty-two states maintain a centralized registry, but requirements for data submission vary significantly. Inclusion and exclusion criteria also vary, particularly for nontraumatic injuries. Coding conventions adopted by states for vague or missing information are dissimilar. When abstractions of the clinical vignette are compared, only 19% and 47% of states provided similar quantity or content for injury e-coding and diagnostic coding, respectively. Injury severity scores (based on diagnostic coding) demonstrated a range from 2 to 18.

Conclusions: Statewide trauma registries are prevalent but vary significantly in composition and content. Standardizing inclusion criteria, variable definitions, and coding conventions would greatly enhance the usability of an aggregated, national trauma registry.