Pediatric trauma registries: the foundation of quality care.
OBJECTIVE
Traumatic injuries cause substantial morbidity and mortality in children. Trauma registries are essential to assess and improve standards of trauma care. An interprovincial study of pediatric trauma between 6 centers across Canada who use identical software components was completed.


METHODS
Data were collected from April 1, 1995 to December 31, 1998 for children aged 1 day to 17 years with an injury severity score of > or = 12. Cause of injury, injury time and day, gender, age, injury scores, length of hospital stay, and outcomes were compared.


RESULTS
A total of 1,276 patients were included. Mean age was 10.3 +/- 5.6 years. Motor vehicle collisions were the most common mechanism of injury (56%). Boys were more often injured (66%; P < .05). Injuries occurred mainly between 1600 and 2400 hours (P < .0001). Mean hospital stay was 11.5 +/- 16.6 days. The longest stays in the hospital were among those who had an abdominal abbreviated injury score (AIS) of 1 (P < or = .03). Patients with similar injury severities remained twice as long in Winnipeg Children's Hospital (hospital 5), hospital 2, and hospital 6 as compared with patients in hospital 3 (P < .05). Differences existed in discharge placement between hospitals (P < .0001).


CONCLUSIONS
This study was the first to compare pediatric patients in multiple Canadian centers using identical trauma registries. Variations in length of stay and discharge placements between hospitals were identified. Further analysis of data in the registries may clarify these differences and serve as a foundation for hospitals to improve the quality of patient care.
Condello
A S
AS
Winnipeg Children's Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
Hancock
B J
BJ
Hoppensack
M
M
Tenenbein
M
M
Stewart
T C
TC
Kirwin
D
D
Williamson
J
J
Findlay
C
C
Moffatt
M
M
Wiseman
N
N
Postuma
R
R
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D017677:Age Distribution; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009017:Morbidity; D009104:Multiple Trauma / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010351:Patient Discharge / Q000706:statistics & numerical data; D010372:Pediatrics / Q000592:standards*; D011787:Quality of Health Care; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D017749:Total Quality Management / Q000458:organization & administration*; D015599:Trauma Severity Indices; D014194:Traumatology / Q000592:standards*