[Nordic accident classification system used in the Danish National Hospital Registration System to register causes of severe traumatic brain injury].
BACKGROUND
The purpose was to illustrate the use of the accident classification system worked out by the Nordic Medico-Statistical Committee (NOMESCO). In particular, registration of causes of severe traumatic brain injury according to the system as part of the Danish National Hospital Registration System was studied.


METHODS
The study comprised 117 patients with very severe traumatic brain injury (TBI) admitted to the Brain Injury Unit of the University Hospital in Hvidovre, Copenhagen, from 1 October 2000 to 30 September 2002. Prospective NOMESCO coding at discharge was compared to independent retrospective coding based on hospital records, and to coding from other wards in the Danish National Hospital Registration System. Furthermore, sets of codes in the Danish National Hospital Registration System for consecutive admissions after a particular accident were compared.


RESULTS
Identical results of prospective and independent retrospective coding were found for 65% of 588 single codes, and complete sets of codes for the same accident were identical only in 28% of cases. Sets of codes for the first admission in a hospital course corresponded to retrospective coding at the end of the course in only 17% of cases. Accident code sets from different wards, based on the same injury, were identical in only 7% of cases.


CONCLUSIONS
Prospective coding by the NOMESCO accident classification system proved problematic, both with regard to correctness and completeness. The system--although logical--seems too complicated compared to the resources invested in the coding. The results of this investigation stress the need for better management and for better instruction to those who carry out the registration.
Engberg
Aase Worsaa
AW
Hvidovre Hospital, Afdeling for Neurorehabilitering, Bispebjerg Hospital, Klinisk Farmakologisk Enhed. aae@dadlnet.dk
Penninga
Elisabeth Irene
EI
Teasdale
Thomas William
TW
D000059:Accidents / Q000145:classification*; D001930:Brain Injuries / Q000145:classification* / Q000209:etiology / Q000534:rehabilitation; D003718:Denmark; D006801:Humans; D009664:Norway; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies