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A public-private collaborative model for a trauma program implementation: findings from a prospective trauma registry
Ezequiel Monteverde1, Marilina Santero2, Laura Bosque1
1Fundación Trauma, Tacuarí 352, CABA, C1071 AAH, Buenos Aires, Argentina.
Insights
Implementing a trauma registry (TR) in developing countries is feasible. This study shows a TR can improve trauma care, injury surveillance, and guide public health policies.
Area of Science:
- Trauma care systems
- Public health policy
- Injury surveillance
Background:
- Trauma is a major cause of death and disability globally, particularly in young people.
- Trauma registries (TR) are crucial for modern trauma care but are lacking in many developing nations.
- This study addresses the implementation of a trauma program and TR in Buenos Aires, Argentina.
Purpose of the Study:
- To summarize challenges, results, and lessons learned from a trauma program.
- To present initial findings from a trauma registry in a resource-limited setting.
- To assess the feasibility of establishing a trauma care system in a developing country.
Main Methods:
- A descriptive study analyzing data from 14 hospitals in Buenos Aires from January 2010 to December 2018.
- Utilized data from the Fundación Trauma TR, including 29,970 trauma cases.
- Analyzed patient demographics, injury mechanisms, severity, complications, treatments, and in-hospital mortality.
Main Results:
- Road traffic injuries (RTIs) were the most common cause (30.8%), with head injuries being most frequent (33.2%).
- Motorcycle accidents accounted for two-thirds of RTIs.
- Overall in-hospital mortality was 6.1%, with intentional self-harm and burns showing the highest rates in specific demographics.
Conclusions:
- Trauma programs and TR implementation are feasible in resource-limited environments through public-private collaboration.
- Hospital-based TRs are valuable tools for injury surveillance and monitoring trauma care quality.
- Data from TRs can inform trauma system development and guide public health policies effectively.
Introduction:
Trauma is a leading cause of mortality and comprises an important cause of functional impairment among young people worldwide. The trauma registry (TR) is an integral component of modern comprehensive trauma care systems. Nevertheless, TRs have not been yet established in most developing countries. The objective of this study was to summarize the challenges, results, and lessons learned from a trauma program including initial results from a TR at tertiary-care public hospitals of Buenos Aires, Argentina.
Material And Methods:
This is a descriptive study of the implementation of a trauma program in 14 hospitals and analysis of the initial results in the period between January 2010 and December 2018, using data from Fundación Trauma TR. Patients fitting injury definition that remained in hospital for more than 23 h were included. Injured patients were divided by age groups. Data on patients' demographics, mechanism of injury and severity, complications, treatments, and in-hospital mortality were analyzed between groups. A descriptive analysis is presented.
Results:
There were 29,970 trauma cases during the study period. Median age was 23 years (RIC 12, 39) with a 2.4:1 male-to-female ratio. Road traffic injuries (RTI) were the leading mechanism (30.8%) of admission and head was the most frequently injured body region (33.2%). Two-thirds of RTIs were motorcycle-related. Overall in-hospital mortality was 6.1%. Intentional self-harm in adult males and burns in adult females had the highest mortality rates (17.6% and 17.9%, respectively).
Conclusions And Discussion:
The implementation of a trauma program within a public-private collaborative program in a resource-limited environment is feasible. The hospital-based TR can be used as a tool for injury surveillance, monitoring of the quality of trauma care, development of a trauma system, and to guide public health policies.
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