Collecting core data in severely injured patients using a consensus trauma template: an international multicentre study

Abstract

IntroductionNo worldwide, standardised definitions exist for documenting, reporting and comparing data from severely injured trauma patients. This study evaluated the feasibility of collecting the data variables of the international consensus-derived Utstein Trauma Template.MethodsTrauma centres from three different continents were invited to submit Utstein Trauma Template core data during a defined period, for up to 50 consecutive trauma patients. Directly admitted patients with a New Injury Severity Score (NISS) equal to or above 16 were included. Main outcome variables were data completeness, data differences and data collection difficulty.ResultsCentres from Europe (n = 20), North America (n = 3) and Australia (n = 1) submitted data on 965 patients, of whom 783 were included. Median age was 41 years (interquartile range (IQR) 24 to 60), and 73.1% were male. Median NISS was 27 (IQR 20 to 38), and blunt trauma predominated (91.1%). Of the 36 Utstein variables, 13 (36%) were collected by all participating centres. Eleven (46%) centres applied definitions of the survival outcome variable that were different from those of the template. Seventeen (71%) centres used the recommended version of the Abbreviated Injury Scale (AIS). Three variables (age, gender and AIS) were documented in all patients. Completeness > 80% was achieved for 28 variables, and 20 variables were > 90% complete.ConclusionsThe Utstein Template was feasible across international trauma centres for the majority of its data variables, with the exception of certain physiological and time variables. Major differences were found in the definition of survival and in AIS coding. The current results give a clear indication of the attainability of information and may serve as a stepping-stone towards creation of a European trauma registry.

Template for documenting and reporting data in physician-staffed pre-hospital services: a consensus-based update

“…Several consensus-based templates for reporting in EMS and p-EMS have been created (e.g., trauma, airway handling and cardiac arrest) [14,15,26,36], and studies have proven that data collection according to such templates are feasible [12,16,37]. However, to increase the relevance of templates, variables should be coordinated.…”

“…Templates for uniform documentation may facilitate international multi-centre studies, thereby increasing the quality of evidence [11]. Such templates, designed through expert agreement, are valuable and feasible, but they need to be updated on a regular basis due to developments in available equipment and treatment options [12][13][14][15]. The p-EMS template has been incorporated for daily use in Finland, but it has not yet been implemented in other European countries.…”

Calidad y registros en trauma

“…El tipo de variables ha de ser homogéneo, consensuado por los profesionales interesados [33][34][35][36] ; deben incluirse las variables de mayor impacto y cobertura para conseguir la máxima representación, en número lo suficientemente reducido para facilitar la participación y lo suficientemente amplio para poder analizar de forma objetiva resultados relacionados con mortalidad, escalas funcionales y de calidad de vida, así como factores médico-sanitarios, sociales y económicos relacionados con el paciente traumatizado. Incluir pocas variables o muy fundamentales puede no dar respuesta a los objetivos de conocimiento planteados; incrementar el número de variables aumenta la complejidad y los costos, y puede comprometer su mantenimiento.…”

Trauma registries in Europe

“…Trauma registries in Europe have reached a consensus agreement on a core dataset for future comparative analyses [1]. A validation study just appeared in the journal Critical Care [2]. This is the first step in the direction of a joint European trauma registry.…”