Developing a trauma registry in a forward deployed military hospital: Preliminary report

Abstract

Background: The 325th Field Surgical Team (FST), a US Army trauma surgical group, was deployed to Afghanistan during Operation Enduring Freedom. Unlike civilian trauma centers, complete trauma registries are lacking from the FST care model.

Methods: A trauma registry was created using a commercially available relational database. Data entry was done using a handheld personal data organizer (PDA).

Results: In 82 days, 125 trauma patients were evaluated and treated. The mean age was 23 +/- 11.69 and 85 (68%) were local Afghan nationals. Most patients were transported by helicopter (83; 66%); the remaining arrived by ground transportation (42; 34%). The average US military casualty arrival time from injury was 1 hour 38 minutes +/-46. The most common injury was gunshot wounds 47(38%) and the mean Injury Severity Score was 9, with 29 (23%) patients scoring > or =15. Initial mean vitals were systolic blood pressure (SBP); 119 +/- 23.7, heart rate; 103 +/- 7.35, respiratory rate; 20 +/- 7.35, and temperature (degrees C); 36.6 +/- 1.6. The median Glasgow Coma Scale was 15, and presenting mean hematocrit and base deficit were 35 +/- 9.56 and -5.02 +/- 5.03, respectively. Operative procedures were performed in 54 (43.2%) patients, and the mean time to surgery from admission was 80 +/- 11.5 minutes. The most common operative procedure was debridement or completion of amputation of lost limb debridement and completion of amputations (13). The average length of stay was 4.37 +/- 2.88 days. The mortality rate was 8%.

Conclusion: The collection of comprehensive prospective data using a PDA can be an efficient and effective method in expanding trauma base registries in forward deployed surgical units.