01.10.2015 | Original Article
Trauma registry comparison: six-year results in trauma care in Southern Finland and Germany
T. Brinck, L. Handolin, T. Paffrath, R. Lefering
European Journal of Trauma and Emergency Surgery
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To compare the treatment and survival of trauma patients in Germany and Southern Finland.
Data from Helsinki University Hospital trauma registry (TR-THEL) and TraumaRegister DGU® (TR-DGU) were compared in a period from 2006 until 2011. From TR-DGU level-one trauma centers treating annually >50 injury severity score (ISS) >15 patients were included. The inclusion criterion was ISS >15. Patients under 16 years with penetrating trauma without head injury and transferred in with isolated head injury were excluded. The compared parameters were age, sex, pre-injury ASA, injury scoring, injury pattern, mechanism of injury, injury distribution, pre-hospital timings, transportation method, pre-hospital intubation, treatment at hospital, discharge destination, and 30-day hospital mortality. Expected mortality was defined with the Revised Injury Severity Classification score (RISC).
Eighty-five German level-one trauma centers were included. A total of 15,306 and 1,274 patients were included in the outcome analysis from TR-DGU and TR-THEL, respectively. The difference between the observed and expected mortality of all patients was −4.1 % (standardized mortality ratio [SMR] 0.82) at German hospitals and −4.0 % (SMR 0.79) in Helsinki. Differences in the pre- and in-hospital treatment between the two countries were noted (transportation method, intubation rate, intensive care unit treatment, ventilation time, length of stay).
The overall outcome results of the Helsinki University Hospital trauma unit were similar to those of the German level-one trauma centers. Registry comparison is a feasible method of quality control in a trauma centre.