Skip to main content
Erschienen in: European Journal of Trauma and Emergency Surgery 6/2021

31.03.2020 | Original Article

A public–private collaborative model for a trauma program implementation: findings from a prospective trauma registry at 14 hospitals in Buenos Aires, Argentina

verfasst von: Ezequiel Monteverde, Marilina Santero, Laura Bosque, Betina Lartigue, Carlos Tenaillon, Joaquín Baliña, Vicente Gutiérrez, Jorge Neira

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 6/2021

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Trauma is a leading cause of mortality and comprises an important cause of functional impairment among young people worldwide. The trauma registry (TR) is an integral component of modern comprehensive trauma care systems. Nevertheless, TRs have not been yet established in most developing countries. The objective of this study was to summarize the challenges, results, and lessons learned from a trauma program including initial results from a TR at tertiary-care public hospitals of Buenos Aires, Argentina.

Material and methods

This is a descriptive study of the implementation of a trauma program in 14 hospitals and analysis of the initial results in the period between January 2010 and December 2018, using data from Fundación Trauma TR. Patients fitting injury definition that remained in hospital for more than 23 h were included. Injured patients were divided by age groups. Data on patients’ demographics, mechanism of injury and severity, complications, treatments, and in-hospital mortality were analyzed between groups. A descriptive analysis is presented.

Results

There were 29,970 trauma cases during the study period. Median age was 23 years (RIC 12, 39) with a 2.4:1 male-to-female ratio. Road traffic injuries (RTI) were the leading mechanism (30.8%) of admission and head was the most frequently injured body region (33.2%). Two-thirds of RTIs were motorcycle-related. Overall in-hospital mortality was 6.1%. Intentional self-harm in adult males and burns in adult females had the highest mortality rates (17.6% and 17.9%, respectively).

Conclusions and discussion

The implementation of a trauma program within a public–private collaborative program in a resource-limited environment is feasible. The hospital-based TR can be used as a tool for injury surveillance, monitoring of the quality of trauma care, development of a trauma system, and to guide public health policies.
Literatur
1.
Zurück zum Zitat Baker SP. Advances and adventures in trauma prevention. J Trauma Acute Care Surg. 1997;42(3):369–73.CrossRef Baker SP. Advances and adventures in trauma prevention. J Trauma Acute Care Surg. 1997;42(3):369–73.CrossRef
2.
Zurück zum Zitat National Research Council (US). Committee on Trauma, & National Research Council (US). Committee on Shock. Accidental death and disability: the neglected disease of modern society. US Department of Health, Education and Welfare, Health Services and Mental Health Administration, Division of Emergency Health Services; 1971. National Research Council (US). Committee on Trauma, & National Research Council (US). Committee on Shock. Accidental death and disability: the neglected disease of modern society. US Department of Health, Education and Welfare, Health Services and Mental Health Administration, Division of Emergency Health Services; 1971.
4.
Zurück zum Zitat MacKenzie EJ, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354(4):366–78.CrossRef MacKenzie EJ, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354(4):366–78.CrossRef
5.
Zurück zum Zitat Sampalis JS, et al. Trauma center designation: initial impact on trauma-related mortality. J Trauma Acute Care Surg. 1995;39(2):232–9.CrossRef Sampalis JS, et al. Trauma center designation: initial impact on trauma-related mortality. J Trauma Acute Care Surg. 1995;39(2):232–9.CrossRef
6.
Zurück zum Zitat Moran CG, et al. Changing the system-major trauma patients and their outcomes in the NHS (England) 2008–17. EClinicalMedicine. 2018;2:13–211.CrossRef Moran CG, et al. Changing the system-major trauma patients and their outcomes in the NHS (England) 2008–17. EClinicalMedicine. 2018;2:13–211.CrossRef
7.
Zurück zum Zitat Rogers FB, et al. Population-based study of hospital trauma care in a rural state without a formal trauma system. J Trauma Acute Care Surg. 2001;50(3):409–14.CrossRef Rogers FB, et al. Population-based study of hospital trauma care in a rural state without a formal trauma system. J Trauma Acute Care Surg. 2001;50(3):409–14.CrossRef
8.
Zurück zum Zitat Nathens AB, et al. Effectiveness of state trauma systems in reducing injury-related mortality: a national evaluation. J Trauma Acute Care Surg. 2000;48(1):25.CrossRef Nathens AB, et al. Effectiveness of state trauma systems in reducing injury-related mortality: a national evaluation. J Trauma Acute Care Surg. 2000;48(1):25.CrossRef
9.
Zurück zum Zitat Sariego J. Impact of a formal trauma program on a small rural hospital in Mississippi. South Med J. 2000;93(2):182–5.CrossRef Sariego J. Impact of a formal trauma program on a small rural hospital in Mississippi. South Med J. 2000;93(2):182–5.CrossRef
10.
Zurück zum Zitat Neira J, Bosque L, Zengotita S. Informe EstadísticoSobre Trauma 2000. Soc Argent Med Cir Trauma Secr SaludGob Ciudad B Aires; 2000. Neira J, Bosque L, Zengotita S. Informe EstadísticoSobre Trauma 2000. Soc Argent Med Cir Trauma Secr SaludGob Ciudad B Aires; 2000.
11.
Zurück zum Zitat Barbieri M, et al. Impacto Familiar, Social y Económico de la Enfermedad Trauma, Un Enfoque Interdisciplinario, Award of the National Academy of Medicine. Bol N Med. 2010;88:583–93. Barbieri M, et al. Impacto Familiar, Social y Económico de la Enfermedad Trauma, Un Enfoque Interdisciplinario, Award of the National Academy of Medicine. Bol N Med. 2010;88:583–93.
12.
Zurück zum Zitat LaScala EA, Gerber D, Gruenewald PJ. Demographic and environmental correlates of pedestrian injury collisions: a spatial analysis. Accid Anal Prev. 2000;32(5):651–8.CrossRef LaScala EA, Gerber D, Gruenewald PJ. Demographic and environmental correlates of pedestrian injury collisions: a spatial analysis. Accid Anal Prev. 2000;32(5):651–8.CrossRef
13.
Zurück zum Zitat Yiannakoulias N, et al. Zones of prevention: the geography of fall injuries in the elderly. Soc Sci Med. 2003;57(11):2065–73.CrossRef Yiannakoulias N, et al. Zones of prevention: the geography of fall injuries in the elderly. Soc Sci Med. 2003;57(11):2065–73.CrossRef
14.
Zurück zum Zitat Ordoñez CA, et al. Trauma Registry of the Pan-American Trauma Society: one year of experience in two hospitals in southwest Colombia. Colombia Medica. 2016;47(3):148–54.CrossRef Ordoñez CA, et al. Trauma Registry of the Pan-American Trauma Society: one year of experience in two hospitals in southwest Colombia. Colombia Medica. 2016;47(3):148–54.CrossRef
15.
Zurück zum Zitat Duron V, et al. Implementation and analysis of initial trauma registry in Iquitos, Peru. Health Promot Perspect. 2016;6(4):174.CrossRef Duron V, et al. Implementation and analysis of initial trauma registry in Iquitos, Peru. Health Promot Perspect. 2016;6(4):174.CrossRef
16.
Zurück zum Zitat O’Reilly GM, et al. Trauma registries in developing countries: a review of the published experience. Injury. 2013;44(6):713–21.CrossRef O’Reilly GM, et al. Trauma registries in developing countries: a review of the published experience. Injury. 2013;44(6):713–21.CrossRef
17.
Zurück zum Zitat CICCATED. Categorización de Centros para la Atención del Paciente Traumatizado en la República Argentina. Bases para la implementa ción de un Programa Institucional. Academia Nacional de Medicina; 2011. CICCATED. Categorización de Centros para la Atención del Paciente Traumatizado en la República Argentina. Bases para la implementa ción de un Programa Institucional. Academia Nacional de Medicina; 2011.
18.
Zurück zum Zitat Baker SP, O'Neill B, Karpf RS. The injury fact book. Lexington, MA. Washington DC: Lexington Books; 1984. Baker SP, O'Neill B, Karpf RS. The injury fact book. Lexington, MA. Washington DC: Lexington Books; 1984.
20.
Zurück zum Zitat Ministerio de Justicia y Derechos Humanos, Protección de los datos personales. In: Ley 25.326. Argentina; 2000. Ministerio de Justicia y Derechos Humanos, Protección de los datos personales. In: Ley 25.326. Argentina; 2000.
21.
Zurück zum Zitat Mock C, et al. Guidelines for trauma quality improvement programmes. Geneva: World Health Organization; 2009 (Google Scholar, 2009).CrossRef Mock C, et al. Guidelines for trauma quality improvement programmes. Geneva: World Health Organization; 2009 (Google Scholar, 2009).CrossRef
22.
Zurück zum Zitat Espinal R. Registro de trauma. Rev Med Hond. 1999;67:258–9. Espinal R. Registro de trauma. Rev Med Hond. 1999;67:258–9.
23.
Zurück zum Zitat Carreiro PRL, et al. Implementation of a trauma registry in a brazilian public hospital: the first 1,000 patients. Revista do Colégio Brasileiro de Cirurgiões. 2014;41:251–5.CrossRef Carreiro PRL, et al. Implementation of a trauma registry in a brazilian public hospital: the first 1,000 patients. Revista do Colégio Brasileiro de Cirurgiões. 2014;41:251–5.CrossRef
24.
Zurück zum Zitat Trostchansky J, et al. Historia clínica para trauma. Registro hospitalario específico para pacientes traumatizados: un recurso para países en desarrollo. Revista Médica del Uruguay. 2011;27(1):12–20. Trostchansky J, et al. Historia clínica para trauma. Registro hospitalario específico para pacientes traumatizados: un recurso para países en desarrollo. Revista Médica del Uruguay. 2011;27(1):12–20.
25.
Zurück zum Zitat Rodriguez C, et al. A trauma registry experience from the main referral center of Honduras: a call for action. Injury. 2019;50(4):883–9.CrossRef Rodriguez C, et al. A trauma registry experience from the main referral center of Honduras: a call for action. Injury. 2019;50(4):883–9.CrossRef
26.
Zurück zum Zitat Ward E, et al. The Jamaica Injury Surveillance System a profile of the intentional and unintentional injuries in Jamaican Hospitals. West Indian Med J. 2010;59(1):07–13. Ward E, et al. The Jamaica Injury Surveillance System a profile of the intentional and unintentional injuries in Jamaican Hospitals. West Indian Med J. 2010;59(1):07–13.
27.
Zurück zum Zitat Scarpelini S, de Andrade JI, Passos ADC. The TRISS method applied to the victims of traffic accidents attended at a tertiary level emergency hospital in a developing country. Injury. 2006;37(1):72–7.CrossRef Scarpelini S, de Andrade JI, Passos ADC. The TRISS method applied to the victims of traffic accidents attended at a tertiary level emergency hospital in a developing country. Injury. 2006;37(1):72–7.CrossRef
28.
Zurück zum Zitat American College of Surgeons. National Trauma Data Bank Report 2016. 2016. American College of Surgeons. National Trauma Data Bank Report 2016. 2016.
Metadaten
Titel
A public–private collaborative model for a trauma program implementation: findings from a prospective trauma registry at 14 hospitals in Buenos Aires, Argentina
verfasst von
Ezequiel Monteverde
Marilina Santero
Laura Bosque
Betina Lartigue
Carlos Tenaillon
Joaquín Baliña
Vicente Gutiérrez
Jorge Neira
Publikationsdatum
31.03.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 6/2021
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-020-01348-7

Weitere Artikel der Ausgabe 6/2021

European Journal of Trauma and Emergency Surgery 6/2021 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.