title: Creation and implementation of an emergency general surgery registry modeled after the National Trauma Data Bank.
abstract: BACKGROUND
  As emergency general surgery (EGS) evolves, an EGS patient-tracking database (EGS registry [EGSR]) similar to the National Trauma Data Bank (NTDB) will be essential to study outcomes and improve care. The goal of this study was to establish diagnostic ICD-9 codes to define EGS patients. The hypothesis was that creating standardized ICD-9-based inclusion criteria would facilitate patient identification for an EGSR and aid in its ongoing development.
  
  
  METHODS
  We conducted a retrospective review of EGS admissions over a 9-month period to define ICD-9 diagnostic codes of patients admitted to our EGS service. Subsequently, prospective data were collected into the EGSR by testing ICD-9-based inclusion criteria over 1 month. Patient, hospital, and severity scoring variables, as well as quality assurance information, were identified.
  
  
  RESULTS
  We identified 959 admissions to the EGS service over 9 months with 306 ICD-9 diagnosis codes that define EGS patients; the prospective population of the EGSR confirmed feasibility of ICD-9-based inclusion criteria. The EGSR captures 107 data points and 33 comorbidities per patient over 11 categories, akin to the 10 NTDB categories.
  
  
  CONCLUSIONS
  Following the model of the NTDB, we have successfully completed creation and initial implementation of an EGSR by using ICD-9-based inclusion criteria. Our comprehensive EGSR creates a prospective data-collection modality to capture and define EGS patients. A uniform patient-tracking EGSR, akin to the NTDB, will advance the science of acute care surgery, improve EGS patient outcomes, and facilitate multi-institutional collaboration.
authors.affiliation: Acute Care Surgery Service, Department of General Surgery, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA. rbecher@wfubmc.edu
authors.forename: Robert D
authors.initials: RD
authors.lastname: Becher
authors.forename: J Wayne
authors.initials: JW
authors.lastname: Meredith
authors.forename: Michael C
authors.initials: MC
authors.lastname: Chang
authors.forename: J Jason
authors.initials: JJ
authors.lastname: Hoth
authors.forename: H Randall
authors.initials: HR
authors.lastname: Beard
authors.forename: Preston R
authors.initials: PR
authors.lastname: Miller
mesh_terms: D015897:Comorbidity; D016208:Databases, Factual; D004635:Emergency Medicine / Q000458:organization & administration*; D013502:General Surgery / Q000458:organization & administration*; D006801:Humans; D038801:International Classification of Diseases; D016730:Program Development; D012042:Registries / Q000592:standards; D012189:Retrospective Studies; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000145:classification*; D014481:United States