Osvaldo Chiara1,1, Alessio Pitidis2, Lucia Lispi3, Silvia Bruzzone4, Carla Ceccolini3, Paola Cacciatore4, Stefania Cimbanassi5, Franco Taggi2. 1. Trauma Team, Emergency Department, Ospedale Niguarda Ca'Granda, Milan, Italy. ochiara@yahoo.com. 2. Department of Environment and Primary Prevention, National Institute of Health, Rome, Italy. 3. General Directorate of Healthcare Planning, Ministry of Health, Rome, Italy. 4. Division for Statistics and Surveys on Social Institutions, Italian National Institute of Statistics, Rome, Italy. 5. Trauma Team, Emergency Department, Ospedale Niguarda Ca'Granda, Milan, Italy.
Abstract
BACKGROUND: Population-based registries have been proposed for epidemiologic studies and quality assessment in trauma care because they consider the entire population of a given geographic area. PATIENTS AND METHODS: Trauma mortality in pre-hospital and in-hospital settings and death time from injury have been calculated for Italy during 2002 by cross-analyzing two national databases: the death certificates register (DCD) and the hospital discharge register (HDR). All diagnosis codes from 800.0 to 939.9 and from 950.0 to 959.9 in both the DCD and the HDR, with the exclusion of femur fractures (820.0 and 821.9) if older than 65, have been included. RESULTS: The total number of people who died during 2002 as a consequence of trauma in Italy was 15,456; of these, 43.5% were older than age 64, and 35.9% belonged to the 15-44 age group. The overall incidence rate of trauma death was 27.23 per 100,000 inhabitants/ year, with a relative risk to men vs. women of 2.3. An analysis of the time distribution of the trauma deaths showed that 46.8% were pre-hospital mortalities, 18% of the deaths occurred within 48 h after hospital admission (acute mortality), 11.2% of the deaths occurred between three and seven days after admission (early mortality), and 24.0% of the patients died more than seven days after admission (late mortality). Patients who died before they arrived at hospital were younger and the proportion of men was higher than for the deaths that occurred after hospital arrival. CONCLUSION: The use of population-based registries proved to be effective in our study because it allowed us to use currently available data to obtain information useful for trauma system planning and design.
BACKGROUND: Population-based registries have been proposed for epidemiologic studies and quality assessment in trauma care because they consider the entire population of a given geographic area. PATIENTS AND METHODS: Trauma mortality in pre-hospital and in-hospital settings and death time from injury have been calculated for Italy during 2002 by cross-analyzing two national databases: the death certificates register (DCD) and the hospital discharge register (HDR). All diagnosis codes from 800.0 to 939.9 and from 950.0 to 959.9 in both the DCD and the HDR, with the exclusion of femur fractures (820.0 and 821.9) if older than 65, have been included. RESULTS: The total number of people who died during 2002 as a consequence of trauma in Italy was 15,456; of these, 43.5% were older than age 64, and 35.9% belonged to the 15-44 age group. The overall incidence rate of trauma death was 27.23 per 100,000 inhabitants/ year, with a relative risk to men vs. women of 2.3. An analysis of the time distribution of the trauma deaths showed that 46.8% were pre-hospital mortalities, 18% of the deaths occurred within 48 h after hospital admission (acute mortality), 11.2% of the deaths occurred between three and seven days after admission (early mortality), and 24.0% of the patients died more than seven days after admission (late mortality). Patients who died before they arrived at hospital were younger and the proportion of men was higher than for the deaths that occurred after hospital arrival. CONCLUSION: The use of population-based registries proved to be effective in our study because it allowed us to use currently available data to obtain information useful for trauma system planning and design.
Authors: Stefano S Granieri; Elisa E Reitano; Francesca F Bindi; Federica F Renzi; Fabrizio F Sammartano; Stefania S Cimbanassi; Shailvi S Gupta; Osvaldo O Chiara Journal: World J Emerg Surg Date: 2020-03-10 Impact factor: 5.469