Reporting data following major trauma and analysing factors associated with outcome using the new Utstein style recommendations

Abstract

Study objective: To collect and present retrospectively the recommended core data from the Utstein style, analyse factors associated with outcome in major trauma, and discuss the value of the Utstein style definition of major trauma.

Design: A retrospective trauma cohort study.

Setting: A Norwegian trauma system with a 1200 bed combined local and referral trauma hospital without a formal trauma registry, covering a population of approximately 2.0 million.

Participants: 3391 injured patients admitted 12 months from January 15, 1996.

Main outcome measures: Recommended core data from the Utstein style, and factors associated with outcome defined as in-hospital death within 30 days.

Results: 225 patients had an injury severity score (ISS)>15. In each of the 225 patients, we were able to obtain at least 47% of the recommended core data. Age >70 years, fall as a mechanism of injury, and a Trauma Score (TS)< or =14 were significantly associated with poor outcome. Of 22 with no major trauma (ISS<16), two died in hospital and 20 had an intensive care unit stay of more than 2 days.

Conclusion: We found it difficult to collect retrospectively the recommended core data of the Utstein style. Age and physiological alterations (TS) were significantly related to outcome. The recommended definition of major trauma (ISS>15) did not cover all life-threatening injuries. The implementation of trauma registries based on the Utstein style recommendations could facilitate system evaluation and comparison, but definitions and categorizations should be further developed. Efforts should be made to reduce the number of core data.