The effect of trauma program registry on reported mortality rates.
BACKGROUND
This study assesses the relationship that the brand of trauma program registry (TPR) has on mortality rate (MR) in the reports prepared by the American College of Surgeons Committee on Trauma (ACSCOT) trauma center (TC) site surveyors.


METHODS
Data from 242 ACSCOT adult TC survey reports (88 Level I, 115 Level II, and 39 Level III) were analyzed for annual trauma volume, injury severity score (ISS), MR, and TPR. Six TPR (A through F) were identified; group F was a composite of several infrequently used TPRs. This report focuses on the ISS range 16-24 because of the likelihood that the mean for each TC would be near 20 and MR is high enough so that a difference, if present, could be statistically documented.


RESULTS
For the total group, MR showed no correlation with TC volume or TC level for ISS 16-24. MR was significantly different according to which TPR was used by the TCs. The MR is less (4.8%) for 14 high volume TCs (over 1200 admits) using TPR A compared with 33 low volume TCs (below 800 admits) using TPR A (6.34%).


CONCLUSIONS
The MR for ISS 16-24 in ACSCOT-surveyed TCs differs within subgroups based on type of TPR utilized. This may reflect improper use of the software programs. Enhanced skill in the application of software programs designed to generate ISS scores is essential if meaningful studies on the effects of improved trauma care on MR are to be conducted. Hand scored ISS by trained personnel may circumvent this problem.
Lucas
C E
CE
Department of Surgery, Wayne State University, Detroit, Michigan, USA.
Buechter
K J
KJ
Coscia
R L
RL
Hurst
J M
JM
Lane
V
V
Meredith
J W
JW
Middleton
J D
JD
Mitchell
F L
FL
Rinker
C F
CF
Tuggle
D
D
Vlahos
A
A
Wilberger
J
J
Yu
P
P
D015986:Confounding Factors, Epidemiologic; D003627:Data Interpretation, Statistical; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D012042:Registries; D014193:Trauma Centers / Q000458:organization & administration*; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000401:mortality*