E E Horton1, P Krijnen1, H M Molenaar1, I B Schipper1. 1. Department of Surgery, Leiden University Medical Center, Postal Zone K6-R, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands.
Abstract
OBJECTIVE: Data in trauma registries need to be reliable when used for evaluation of injury management, trauma protocols and hospital statistics. The aim of this audit was to analyse the reliability of the data in the Trauma Centre West Netherlands (TCWN) region. DESIGN: Routinely registered trauma patients from all nine hospitals in the TCWN region were re-registered by a registrar for analysis. SETTING: Nine hospitals in the TCWN region in the Netherlands. PARTICIPANTS: A randomly selected representative trauma population sample of 350 patients and a sample of 100 polytrauma patients were re-registered and used for analysis. INTERVENTION: Re-registration of trauma patients in the Trauma Registry. MAIN OUTCOME MEASURE(S): The inter-rater agreement on Injury Severity Score (ISS), number of Abbreviated Injury Scale (AIS) codes, identical codes and survival status were analysed using Kappa's coefficient and intraclass correlation coefficients. RESULTS: The inter-rater agreement on ISS and number of AIS codes were, respectively, almost perfect (ICC = 0.81) and substantial (ICC = 0.76) in the trauma population sample, and substantial (ICC = 0.70) and fair (ICC = 0.33) in the polytrauma sample. For patients with serious injuries (AIS ≥ 2) in the population sample, the inter-rater agreement on ISS (ICC = 0.87) and number of AIS codes (ICC = 0.84) were almost perfect. CONCLUSIONS: These results confirm that the Dutch regional registry system works well and may serve as a reliable basis for prospective analysis of national and international trauma care. Particular attention should be paid to the coding of polytrauma patients as discrepancies are more likely to occur in this group.
OBJECTIVE: Data in trauma registries need to be reliable when used for evaluation of injury management, trauma protocols and hospital statistics. The aim of this audit was to analyse the reliability of the data in the Trauma Centre West Netherlands (TCWN) region. DESIGN: Routinely registered trauma patients from all nine hospitals in the TCWN region were re-registered by a registrar for analysis. SETTING: Nine hospitals in the TCWN region in the Netherlands. PARTICIPANTS: A randomly selected representative trauma population sample of 350 patients and a sample of 100 polytrauma patients were re-registered and used for analysis. INTERVENTION: Re-registration of trauma patients in the Trauma Registry. MAIN OUTCOME MEASURE(S): The inter-rater agreement on Injury Severity Score (ISS), number of Abbreviated Injury Scale (AIS) codes, identical codes and survival status were analysed using Kappa's coefficient and intraclass correlation coefficients. RESULTS: The inter-rater agreement on ISS and number of AIS codes were, respectively, almost perfect (ICC = 0.81) and substantial (ICC = 0.76) in the trauma population sample, and substantial (ICC = 0.70) and fair (ICC = 0.33) in the polytrauma sample. For patients with serious injuries (AIS ≥ 2) in the population sample, the inter-rater agreement on ISS (ICC = 0.87) and number of AIS codes (ICC = 0.84) were almost perfect. CONCLUSIONS: These results confirm that the Dutch regional registry system works well and may serve as a reliable basis for prospective analysis of national and international trauma care. Particular attention should be paid to the coding of polytrauma patients as discrepancies are more likely to occur in this group.
Authors: Anna Bågenholm; Ina Lundberg; Bjørn Straume; Rune Sundset; Kristian Bartnes; Tor Ingebrigtsen; Trond Dehli Journal: BMC Emerg Med Date: 2019-10-30