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World Journal of Surgery
Erschienen in: World Journal of Surgery 8/2014

01.08.2014

Benchmarking of Trauma Care Worldwide: The Potential Value of an International Trauma Data Bank (ITDB)

verfasst von: Adil H. Haider, Zain G. Hashmi, Sonia Gupta, Syed Nabeel Zafar, Jean-Stephane David, David T. Efron, Kent A. Stevens, Hasnain Zafar, Eric B. Schneider, Eric Voiglio, Raul Coimbra, Elliott R. Haut

Erschienen in: World Journal of Surgery | Ausgabe 8/2014

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Abstract

Background

National trauma registries have helped improve patient outcomes across the world. Recently, the idea of an International Trauma Data Bank (ITDB) has been suggested to establish global comparative assessments of trauma outcomes. The objective of this study was to determine whether global trauma data could be combined to perform international outcomes benchmarking.

Methods

We used observed/expected (O/E) mortality ratios to compare two trauma centers [European high-income country (HIC) and Asian lower-middle income country (LMIC)] with centers in the North American National Trauma Data Bank (NTDB). Patients (≥16 years) with blunt/penetrating injuries were included. Multivariable logistic regression, adjusting for known predictors of trauma mortality, was performed. Estimates were used to predict the expected deaths at each center and to calculate O/E mortality ratios for benchmarking.

Results

A total of 375,433 patients from 301 centers were included from the NTDB (2002–2010). The LMIC trauma center had 806 patients (2002–2010), whereas the HIC reported 1,003 patients (2002–2004). The most important known predictors of trauma mortality were adequately recorded in all datasets. Mortality benchmarking revealed that the HIC center performed similarly to the NTDB centers [O/E = 1.11 (95 % confidence interval (CI) 0.92–1.35)], whereas the LMIC center showed significantly worse survival [O/E = 1.52 (1.23–1.88)]. Subset analyses of patients with blunt or penetrating injury showed similar results.

Conclusions

Using only a few key covariates, aggregated global trauma data can be used to adequately perform international trauma center benchmarking. The creation of the ITDB is feasible and recommended as it may be a pivotal step towards improving global trauma outcomes.
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Metadaten
Titel
Benchmarking of Trauma Care Worldwide: The Potential Value of an International Trauma Data Bank (ITDB)
verfasst von
Adil H. Haider
Zain G. Hashmi
Sonia Gupta
Syed Nabeel Zafar
Jean-Stephane David
David T. Efron
Kent A. Stevens
Hasnain Zafar
Eric B. Schneider
Eric Voiglio
Raul Coimbra
Elliott R. Haut
Publikationsdatum
01.08.2014
Verlag
Springer US
Erschienen in
World Journal of Surgery / Ausgabe 8/2014
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2629-5

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