Development of a statewide trauma registry

Area of Science:

• Trauma Care and Systems Research
• Public Health Surveillance
• Medical Informatics

Background:

• Established in October 1986, the Pennsylvania Trauma Systems Foundation (PTSF) initiated a statewide trauma registry.
• The registry's development focused on critical aspects: data elements, patient selection, mandatory trauma center participation, and reporting mechanisms.

Purpose of the Study:

• To assess the implementation and initial outcomes of a statewide trauma registry.
• To identify challenges and key data points for effective trauma system management.

Main Methods:

• Development of a statewide registry by the PTSF, incorporating data elements, patient selection criteria, and mandatory trauma center involvement.
• Analysis of compliance rates and data completeness for prehospital run times and admission trauma scores.

Main Results:

• Overall trauma center compliance reached 81.5%.
• Documentation rates for prehospital run times (21%) and admission trauma scores (70%) highlight data gaps.
• Patients aged 55 and older represented 27.9% of cases, exhibiting double the mortality rate of younger patients, with falls being the primary injury mechanism (76%).
• A significant proportion of survivors (42.6%) experienced moderate to severe disabilities.

Conclusions:

• Defining a "major trauma patient" presents challenges for registry uniformity and cost-effectiveness.
• Maintaining an active, high-quality registry is crucial for the cost-effectiveness of organized trauma systems, comparable in importance to direct medical care.