Are statewide trauma registries comparable? Reaching for a national trauma dataset.
BACKGROUND
Statewide trauma registries have proliferated in the last decade, suggesting that information could be aggregated to provide an accurate depiction of serious injury in the United States.


OBJECTIVE
To determine whether variability exists in the composition and content of statewide trauma registries, specifically addressing case-acquisition, case-definition (inclusion criteria), and registry-coding conventions.


METHODS
A cross-sectional, two-part survey was administered to managers of all statewide trauma registries. State trauma registrars also provided inclusion and exclusion criteria from their state registry and abstracted a clinical vignette designed to identify coding inconsistencies.


RESULTS
Thirty-two states maintain a centralized registry, but requirements for data submission vary significantly. Inclusion and exclusion criteria also vary, particularly for nontraumatic injuries. Coding conventions adopted by states for vague or missing information are dissimilar. When abstractions of the clinical vignette are compared, only 19% and 47% of states provided similar quantity or content for injury e-coding and diagnostic coding, respectively. Injury severity scores (based on diagnostic coding) demonstrated a range from 2 to 18.


CONCLUSIONS
Statewide trauma registries are prevalent but vary significantly in composition and content. Standardizing inclusion criteria, variable definitions, and coding conventions would greatly enhance the usability of an aggregated, national trauma registry.
Mann
N Clay
NC
Department of Pediatrics, Intermountain Injury Control Research Center, University of Utah, School of Medicine, 295 Chipeta Way, P.O. Box 581289, Salt Lake City, UT 84158-1289, USA. clay.mann@hsc.utah.edu
Guice
Karen
K
Cassidy
Laura
L
Wright
Dagan
D
Koury
Julie
J
D003430:Cross-Sectional Studies; D005568:Forms and Records Control / Q000592:standards / Q000706:statistics & numerical data; D017408:Guidelines as Topic; D006801:Humans; D015601:Injury Severity Score; D038801:International Classification of Diseases; D012042:Registries / Q000592:standards / Q000706:statistics & numerical data*; D013219:State Government; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*