Direct costs of ICU days vary widely between the seven departments. Our standardized costing methodology could serve as a valuable instrument to compare actual cost differences, such as those resulting from differences in patient case-mix.

BackgroundThe aim of this study, conducted in 2006, was to find out whether changes in sedation management in German intensive care units took place in comparison with our survey from 2002.MethodsWe conducted a follow-up survey with a descriptive and comparative cross-sectional multi-center design. A postal survey was sent between January and May 2006, up to four times, to the same 269 hospitals that participated in our first survey in 2002. The same questionnaire as in 2002 was used with a few additional questions.ResultsTwo hundred fourteen (82%) hospitals replied. Sixty-seven percent of the hospitals carried out changes in sedation management since the 2002 survey. Reasons for changes were published literature (46%), national guidelines (29%), and scientific lectures (32%). Sedation protocols (8% versus 52%) and a sedation scale (21% versus 46%) were used significantly more frequently. During sedation periods of up to 24 hours, significantly less midazolam was used (46% versus 35%). In comparison to 2002, sufentanil and epidural analgesia were used much more frequently in all phases of sedation, and fentanyl more rarely. For periods of greater than 72 hours, remifentanil was used more often. A daily sedation break was introduced by 34% of the hospitals, and a pain scale by 21%.ConclusionThe increased implementation of protocols and scoring systems for the measurement of sedation depth and analgesia, a daily sedation break, and the use of more short-acting analgesics and sedatives account for more patient-oriented analgesia and sedation in 2006 compared with 2002.

When benchmarking cancellation rates among hospitals, comparisons should control for academic institutions having higher incidences of case cancellation than nonacademic hospitals and general surgery services having higher incidences than other services.

Objectives: To develop the first Spanish Pediatric Trauma Registry to collect and evaluate infornation concerning aspects of injuries in our pediatric population. Methods: From January 1995 to August 1998.946 children younger than 16 years were treated in our hospital for acute injury: 1500 were admitted and ineluded in our database. Dur file registry consists of 108 data points ineluding: patient identification, type. place and mechanism of injury, pre-hospital care, transport, assess· ment on admission, severity scores, diagnostic studies, injuries, treatment morbidity and mortality. Results: Aceidents were more frequent in males (68 %) than in fern ales. The predominant age group was 12 -15 years of age (34%). Aceidents were more frequent in the street (35.1 %) than at horne (18.9%) or school (13%). Falls and traffic-related aceidents were the leading cause of injury (39% and 21.2%, respectively). Two hundred and thirty-five (15.7%) had a Pediatric Trauma Score::; 8. Fifty of these sustained multiple trauma (33 %) (Injury Severity Scorẽ 15). Musculoskeletal and head trauma were the most frequent injuries (48.5% and 42.0%, respectively). Surgical or orthopedic procedures were performed in 906 patients (56.5 %). The average Jength of stay was 4.5 days (range 1 -93 days). Functional impairment in children older than 4 years of age was found in 413 children (33.3 %). We encountered 7 deaths in the 1500 patients, or an overall mortality of 0.5%. These 7 deaths were only seen in the I.S.S.~15 group (50 patients) with 14% mortality. Conclusions: The goals of this Registry are to estabJish the epidemiology of our injured pediatric population, to review patient care, to deveJop prevention programs and to compare results with other centers so that potential deficieneies can be corrected.• Key words: Pediatric Trauma -Registry -Epidemiology Resume Objectifs: Developper le premier registre des traumatismes pediatriques espagnol pour appreeier Jes differents aspects des traumatismes dans notre population pediatrique. Methodes:Eur