Trauma Registries and Public Health Surveillance of Injuries

Trauma registries are a potential source of part of the data needed for comprehensive public health surveillance of injuries. Like other disease registries, those for trauma are used to collect, store and retrieve data describing the etiologic factors, demographic characteristics, diagnoses, treatments, and clinical outcomes of individuals who meet specified case criteria. In the U.S., the scope of trauma registry case criteria tends to be limited to the most seriously injured individuals who receive hospital care for blunt or penetrating traumatic injuries or burns. Trauma registries are used primarily to monitor and evaluate trauma care at the hospital, regional, and State levels. Multi-hospital trauma registries most often have emerged in geographic areas where emergency medical services (EMS) agencies are planning or administering regional trauma care systems: Several factors have impeded the use of regional trauma registries for calculation of population-based rates of traumatic injury. First, participation in multi-hospital registries often is limited to trauma center hospitals, and even at these specializ, ed centers there are persistent concerns about the completeness of case ascertainment and data quality. Second, injuries that do not require hospitalization usually are excluded from these registries, as are prehospital deaths. Pressures on all acute care hospitals in the U.S. to collect and report standardized trauma care data are mounting, created in large part by hospital accrediting bodies and EMS agencies. These external pressures, coupled with a renewed interest in health care outcomes in general, have created opportunities to extend the coverage of trauma registries, thereby enhancing their potential value for public health surveillance and other purposes.