Injury registration for primary prevention in a provincial Russian region: setting up a new trauma registry

The Shenkursk Injury Registry (SHIR) was established in the Shenkursk District, Northwestern Russia in 2015 for the purposes of primary prevention. The SHIR covers all injuries (ICD-10 diagnoses from S00 to T78) for which medical aid is given at the Shenkursk central district hospital and includes data about injury circumstances. We used the SHIR data to assess the quality of the SHIR as an evidence basis and for the local preventive applications.

Completeness, representativeness, and reliability of the SHIR data were assessed using a sample of 1696 injuries which have occurred in July 2015-June 2016. Chi-square tests were used to assess differences between the registered and missed cases in the registry and Cohen's kappa were applied to assess the agreement between independent data entries.

The completeness of the SHIR with respect to the coverage of cases treated at the Shenkursk central district hospital was 86%. There were no differences between the registered and the missed injuries by sex, ICD-10 codes, weekday of admission, but there were differences in their distribution by attending physicians. Also, higher proportions of child injuries and injuries in the summer time were among the missed cases. Signs of lower injury severity (different distribution by ICD-10 codes and lower proportion of traffic injuries) were observed among injuries in rural areas which were not covered by the registry because of treatment at rural primary health care units without referrals to the central hospital. Two independent data entries from standard paper injury registration forms showed a 79-99% agreement, depending on the variable considered.

With consideration of possible insubstantial overestimates of the average injury severity, the SHIR data can be considered sufficiently complete, reliable, and representative of the injury situation in the Shenkursk District. Therefore, SHIR is an adequate evidentiary basis for planning local injury prevention.