Development and pilot implementation of a locally developed Trauma Registry: Lessons learnt in a low-income country

被引：52
作者：
Mehmood A. [1 ]
Razzak J.A. [1 ]
Kabir S. [1 ]
MacKenzie E.J. [2 ]
Hyder A.A. [2 ,3 ]
机构：
[1] Department of Emergency Medicine, Aga Khan University, Karachi
[2] Bloomberg School of Public Health, John Hopkins University, Baltimore
[3] Johns Hopkins International Injury Research Unit, Bloomberg School of Public Health, Baltimore
来源：
BMC Emergency Medicine | / 13卷 / 1期
基金：
美国国家卫生研究院;
关键词：
Injury; Outcome; Pakistan; Surveillance; Trauma registry;
D O I：
10.1186/1471-227X-13-4
中图分类号：
学科分类号：
摘要：
Background: Trauma registries (TRs) play an integral role in the assessment of trauma care quality. TRs are still uncommon in developing countries owing to awareness and cost. We present a case study of development and pilot implementation of " Karachi Trauma Registry" (KITR), using existing medical records at a tertiary-care hospital of Karachi, Pakistan to present results of initial data and describe its process of implementation.Methods: KITR is a locally developed, customized, electronic trauma registry based on open source software designed by local software developers in Karachi. Data for KITR was collected from November 2010 to January 2011. All patients presenting to the Emergency Department (ED) of the Aga Khan University Hospital (AKUH) with a diagnosis of injury as defined in ICD-9 CM were included. There was no direct contact with patients or health care providers for data collection. Basic demographics, injury details, event detail, injury severity and outcome were recorded. Data was entered in the KITR and reports were generated.Results: Complete data of 542 patients were entered and analysed. The mean age of patients was 27 years, and 72.5% were males. About 87% of patients had sustained blunt injury. Falls and motor vehicle crashes were the most common mechanisms of injury. Head and face, followed by the extremities, were the most frequently injured anatomical regions. The mean Injury Severity Score (ISS) was 4.99 and there were 8 deaths. The most common missing variables in the medical records were ethnicity, ED notification prior to transfer, and pre-hospital IV fluids. Average time to review each chart was 14.5 minutes and entry into the electronic registry required 15 minutes.Conclusion: Using existing medical records, we were able to enter data on most variables including mechanism of injuries, burden of severe injuries and quality indicators such as length of stay in ED, injury to arrival delay, as well as generate injury severity and survival probability but missed information such as ethnicity, ED notification. To make the data collection process more effective, we propose provider based data collection or making a standardized data collection tool a part of medical records. © 2013 Mehmood et al.; licensee BioMed Central Ltd.
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共 29 条
[1]  
Nwomeh, B.C., Lowell, W., Kable, R., Haley, K., Ameh, E.A., History and development of trauma registry: lessons from developed to developing countries (2006) World Journal of Emergency Surgery, 1 (1), p. 32. , 10.1186/1749-7922-1-32, 1635421, 17076896
[2]  
Pollock, D.A., Trauma registries and public health surveillance of injuries (1995) Proc Int Collab Effort Injury Statistics, Vol I DHHS Publ No (PHS) 95-1252: 1995, p. 3. , Washington, D.C: Department of Health and Human Services
[3]  
Rutledge, R., The goals, development, and use of trauma registries and trauma data sources in decision making in injury (1995) Surg Clin North Am, 75 (2), p. 305
[4]  
Arts, D.G.T., De Keizer, N.F., Scheffer, G.J., Defining and improving data quality in medical registries: a literature review, case study, and generic framework (2002) J Am Med Inform Assoc, 9 (6), pp. 600-611. , 10.1197/jamia.M1087, 349377, 12386111
[5]  
Clark, D.E., Hahn, D.R., Hospital trauma registries linked with population-based data (1999) J Trauma, 47 (3), p. 448. , 10.1097/00005373-199909000-00003, 10498296
[6]  
Lucas, C.E., Buechter, K.J., Coscia, R.L., Hurst, J.M., Lane, V., Meredith, J.W., Middleton, J.D., Tuggle, D., The effect of trauma program registry on reported mortality rates (2001) J Trauma, 51 (6), p. 1122. , 10.1097/00005373-200112000-00018, 11740264
[7]  
Moore, L., Clark, D.E., The value of trauma registries (2008) Injury, 39 (6), pp. 686-695. , 10.1016/j.injury.2008.02.023, 18511052
[8]  
Williams, J.M., Furbee, P.M., Prescott, J.E., Paulson, D.J., The emergency department log as a simple injury-surveillance tool (1995) Ann Emerg Med, 25 (5), pp. 686-691. , 10.1016/S0196-0644(95)70184-2, 7741348
[9]  
Nathens, A.B., Brunet, F.P., Maier, R.V., Development of trauma systems and effect on outcomes after injury (2004) Lancet, 363 (9423), pp. 1794-1801. , 10.1016/S0140-6736(04)16307-1, 15172780
[10]  
Shapiro, M.J., Cole, K.E., Keegan, M., Prasad, C.N., Thompson, R.J., National survey of state trauma registries-1992 (1994) J Trauma, 37 (5), p. 835. , 10.1097/00005373-199411000-00022, 7966486
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