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HOME > J Korean Soc Traumatol > Volume 15(2); 2002 > Article
Trauma Registry with ICD-10-based ICISS
Journal of Trauma and Injury 2002;15(2):71-81
DOI: https://doi.org/
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Ewha Womans University, College of Medicine, Department of Emergency Medicine

Backgound: The trauma registry is essential for improving the quality of trauma care. Reappraisal of trauma care adequacy can be performed based on the trauma registry. A trauma
care quality assessment tool should be made so that it will be able to stratify the trauma centers and to estimate the effectiveness of the trauma care system. No data collection system for a trauma registry exists in Korea. Moreover, objective assessment of trauma care has not been tried until now. Existing trauma registries, which are used mainly in developed countries, include all admitted patients, and data collections for those registries is made using extra systems, so the cost of maintenance is high. we were preferentially concerned with severely injured patients, so we began with a small trauma registry focusing only high-risk patients. We also used Internation Classificotion of Direase based Injury Severely Score(ICISS) loth Eddtion(ICD-10) which is routinely made at hospital records offices, instead of the Trauma and Injury Severely Score(TRISS) which is gold standard for registries but needs a special registrar and extra education. Methods : Inclusion criteria for registration were as follows; abnormal RTS (Revised Trauma Score) on admission, injury mechanisms of falls from 5 m or higher and penetrating injuries on the head/neck/trunk, mortality within 48 hours after ED arrival, ICU admission, and emergency operation within 24 hours. Two audit filters, mortality and delayed operation, were applied, and the medical records were rated for trauma care adequacy. The review committee was composed of an emergency physician, a general surgeon, a neurosurgeon, an anethesiologist, and a coordinator. Results : We conducted the registry system during the month of May 2001 at our University hospital. During that period, a total of 4676 patients visited our ED, 1051 (22.5%) patients were injured, and of these, 120 (11.4%) patients were hospitalized. Thirty two patients were included into the trauma registry (3.04% of the total injured and 26.7% of the those hospitalized). The committee reviewed 11 cases (9 patients, 28.1% of the registry patients), 6 mortalities, and 5 delayed operations. The mean ICISS of all registry patients was 0.7930, and the actual mortality rate was 18.8%. Two mortalities were analyzed as preventable deaths based on the ICISS and were judged as the same by the review committee. Conclusion : A curtailed trauma registry could reduce the patient volume to one fourth and might reduce the cost markedly. The trauma committee could manag problems effectively and may make significant improvements in trauma care.

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