THE UTILITY OF A MULTICENTER REGIONAL TRAUMA REGISTRY

We report on the experience of five trauma receiving hospitals (four g eneral hospitals and one spinal cord unit) in establishing a multicent er trauma registry (TR) for the purpose of data sharing. To ensure dat a comparability, all coders were oriented to standard data definitions and injury severity scaling. Coders and their physician sponsors met regularly to review data. Data presented for the four general hospital s from January through September 1992 address comparison of mortality rates, resource implications of isolated hip fractures, and the utilit y of knowing regional neurosurgical (NS) trauma volumes. Because of a statistically significant higher mortality rate at hospital 2, 7.2% ve rsus 4.7% overall, mortality data were further characterized by patien t age, mean ISS, and frequency of severe head injury. This still faile d to explain the mortality difference. Hip fractures utilized 11,120 ( 26.3%) of the total 42,341 TR hospital days. Interhospital differences in median length of stay in this population suggest that greater reso urce efficiencies can be realized. Earlier questions about the value o f including isolated hip fractures in the data set have been answered by understanding the resource implications of this population. Problem s of NS coverage arising from a regional shortage of neurosurgeons can now be addressed with a better appreciation of the intraregional diff erences in NS volumes. Use of congruent data sets, combined with a col laborative approach, has stimulated the application of multicenter TR data to quality improvement, and utilization and regional planning iss ues.