M L S Driessen1, L M Sturms2, F W Bloemers3, H J Ten Duis4, M J R Edwards5, D den Hartog6, M A C de Jongh7, P A Leenhouts8, M Poeze9, I B Schipper10, W R Spanjersberg11, K W Wendt12, R J de Wit13, S van Zutphen14, L P H Leenen15. 1. Dutch Network for Emergency Care (LNAZ), Newtonlaan 115,Utrecht 3584, BH, The Netherlands. Electronic address: mls.driessen@lnaz.nl. 2. Dutch Network for Emergency Care (LNAZ), Newtonlaan 115,Utrecht 3584, BH, The Netherlands. 3. Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands. 4. University of Groningen, The Netherlands. 5. Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. 6. Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. 7. Brabant Trauma Registry, Network Emergency Care Brabant, Tilburg, the Netherlands. 8. Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. 9. Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. 10. Department of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands. 11. Department of Trauma Surgery, Isala Klinieken, Zwolle, The Netherlands. 12. Department of Trauma Surgery, University Medical Center Groningen, Groningen, The Netherlands. 13. Department of Trauma Surgery, Medisch Spectrum Twente, Enschede, The Netherlands. 14. Department of Surgery Elisabeth Tweesteden Ziekenhuis, Tilburg, The Netherlands. 15. Dutch Network for Emergency Care (LNAZ), Newtonlaan 115,Utrecht 3584, BH, The Netherlands; Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Abstract
INTRODUCTION: Twenty years ago the Dutch trauma care system was reformed by the designating 11 level one Regional trauma centres (RTCs) to organise trauma care. The RTCs set up the Dutch National Trauma Registry (DNTR) to evaluate epidemiology, patient distribution, resource use and quality of care. In this study we describe the DNTR, the incidence and main characteristics of Dutch acutely admitted trauma patients, and evaluate the value of including all acute trauma admissions compared to more stringent criteria applied by the national trauma registries of the United Kingdom and Germany. METHODS: The DNTR includes all injured patients treated at the ED within 48 hours after trauma and consecutively followed by direct admission, transfers to another hospital or death at the ED. DNTR data on admission years 2007-2018 were extracted to describe the maturation of the registry. Data from 2018 was used to describe the incidence rate and patient characteristics. Inclusion criteria of the Trauma Audit and Research (TARN) and the Deutsche Gesellschaft für Unfallchirurgie (DGU) were applied on 2018 DNTR data. RESULTS: Since its start in 2007 a total of 865,460 trauma cases have been registered in the DNTR. Hospital participation increased from 64% to 98%. In 2018, a total of 77,529 patients were included, the median age was 64 years, 50% males. Severely injured patients with an ISS≥16, accounted for 6% of all admissions, of which 70% was treated at designated RTCs. Patients with an ISS≤ 15were treated at non-RTCs in 80% of cases. Application of DGU or TARN inclusion criteria, resulted in inclusion of respectively 5% and 32% of the DNTR patients. Particularly children, elderly and patients admitted at non-RTCs are left out. Moreover, 50% of ISS≥16 and 68% of the fatal cases did not meet DGU inclusion criteria CONCLUSION: The DNTR has evolved into a comprehensive well-structured nationwide population-based trauma register. With 80,000 inclusions annually, the DNTR has become one of the largest trauma databases in Europe The registries strength lies in the broad inclusion criteria which enables studies on the burden of injury and the quality and efficiency of the entire trauma care system, encompassing all trauma-receiving hospitals.
INTRODUCTION: Twenty years ago the Dutch trauma care system was reformed by the designating 11 level one Regional trauma centres (RTCs) to organise trauma care. The RTCs set up the Dutch National Trauma Registry (DNTR) to evaluate epidemiology, patient distribution, resource use and quality of care. In this study we describe the DNTR, the incidence and main characteristics of Dutch acutely admitted traumapatients, and evaluate the value of including all acute trauma admissions compared to more stringent criteria applied by the national trauma registries of the United Kingdom and Germany. METHODS: The DNTR includes all injured patients treated at the ED within 48 hours after trauma and consecutively followed by direct admission, transfers to another hospital or death at the ED. DNTR data on admission years 2007-2018 were extracted to describe the maturation of the registry. Data from 2018 was used to describe the incidence rate and patient characteristics. Inclusion criteria of the Trauma Audit and Research (TARN) and the Deutsche Gesellschaft für Unfallchirurgie (DGU) were applied on 2018 DNTR data. RESULTS: Since its start in 2007 a total of 865,460 trauma cases have been registered in the DNTR. Hospital participation increased from 64% to 98%. In 2018, a total of 77,529 patients were included, the median age was 64 years, 50% males. Severely injured patients with an ISS≥16, accounted for 6% of all admissions, of which 70% was treated at designated RTCs. Patients with an ISS≤ 15were treated at non-RTCs in 80% of cases. Application of DGU or TARN inclusion criteria, resulted in inclusion of respectively 5% and 32% of the DNTRpatients. Particularly children, elderly and patients admitted at non-RTCs are left out. Moreover, 50% of ISS≥16 and 68% of the fatal cases did not meet DGU inclusion criteria CONCLUSION: The DNTR has evolved into a comprehensive well-structured nationwide population-based trauma register. With 80,000 inclusions annually, the DNTR has become one of the largest trauma databases in Europe The registries strength lies in the broad inclusion criteria which enables studies on the burden of injury and the quality and efficiency of the entire trauma care system, encompassing all trauma-receiving hospitals.
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