Linking data from national trauma and rehabilitation registries.
OBJECTIVE
To evaluate te feasibility of retrospectively creating a data base useful in trauma systems evaluations.


METHODS
Records for 375 patients in both the Major Trauma Outcome Study and the Uniform Data System for Medical Rehabilitation were linked to create an injury-through-rehabilitation data base, including patients from four impairment groups: traumatic brain injury (TBI); spinal cord injury --paraplegic complete (SCI-PARA) and quadriplegic complete (SCI-QUAD); and hip fracture (HIP-FX).


RESULTS
The average ages (25.1 years SCI-QUAD, 72.6 years HIP-FX); Injury Severity Score (10.2 HIP-FX, 31.7 SCI-PARA); Revised Trauma Score (5.9 TBI, 7.8 HIP-FX); and acute care lengths of stay (13.3 days HIP-FX, 24.2 days TBI) varied substantially over the four groups. On average, patients spent from approximately 20 days (HIP-FX) to nearly 100 days (SCI-QUAD) in rehabilitation. Functional gains during rehabilitation were primarily in motor skills, but TBI patients also made substantial cognitive gains. Nearly 90% of TBI and SCI patients were discharged to their homes; the percentage of HIP-FX patients discharged to their homes, however, was lower (74%). Across all impairment groups, more patients lived with their relatives after rather than before injury. The correlation between a summary Major Trauma Outcome Study-Functional Independence Measure assessed at acute care discharge and the complete Uniform Data System for Medical Rehabilitation-Functional Independence Measure assessed on admission to rehabilitation was significant for all study patients and for each impairment group except SCI_PARA.


CONCLUSIONS
Linking records to create the study data base was arduous and could not be practically accomplished on a large scale or on a continuing basis. Because of the growing emphases on trauma system evaluations and outcomes beyond survival at acute care discharge, we recommend the routine inclusion of rehabilitation data in hospital-based trauma registries.
Copes
W S
WS
Tri-Analytics, Inc., Bel Air, Maryland, USA.
Stark
M M
MM
Lawnick
M M
MM
Tepper
S
S
Wilkerson
D
D
DeJong
G
G
Brannon
R
R
Hamilton
B B
BB
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology* / Q000534:rehabilitation*; D012042:Registries; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D015996:Survival Rate; D014193:Trauma Centers; D016896:Treatment Outcome; D017432:Unified Medical Language System; D014481:United States / Q000453:epidemiology