Hospital trauma registries linked with population-based data

We sought to obtain more reliable population-based data for injury epidemiology and trauma system evaluation by linking several sources.

In the state of Maine, probabilistic computer methods were used to link data from hospitals contained in a trauma registry for 1995 to 1996 to data from the same years contained in death certificates, ambulance run reports, and hospital discharge abstracts. The most reliable data available from each source were merged to form a standard record for each identifiable case of acute trauma.

A total of 8,924 cases of serious injury were identified that either were in the registry, had a death certificate, or had both an ambulance run report and a hospital discharge abstract. Only 74% of the Trauma Center cases and 33% of the cases overall were contained in the registry. Only 84% of fatal hospitalized cases matched to a death certificate. Incompleteness of the registry and occasional failures to match records from one source to another were attributable to intentional omissions and a variety of human data management problems.

Combining sources of data for injury victims can produce a resource more descriptive than any single source alone. However, computer-assisted record linkage still requires human review and corrections. Feedback of discrepancies to the individual data sources should further improve the quality of data available for linkage.