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Review
. 2017 May 31;2(1):e000106.
doi: 10.1136/tsaco-2017-000106. eCollection 2017.

Methodology to reliably measure preventable trauma death rate

Stacy A Drake  1 , Dwayne A Wolf  2 , Janet C Meininger  1 , Stanley G Cron  3 , Thomas Reynold  4 , Charles E Wade  5 , John B Holcomb  5
Affiliations
Review

Methodology to reliably measure preventable trauma death rate

Stacy A Drake et al. Trauma Surg Acute Care Open. .

Abstract

This article describes a methodology to establish a trauma preventable death rate (PDR) in a densely populated county in the USA. Harris County has >4 million residents, encompasses a geographic area of 1777 square miles and includes the City of Houston, Texas. Although attempts have been made to address a national PDR, these studies had significant methodological flaws. There is no national consensus among varying groups of clinicians for defining preventability or documenting methods by which preventability is determined. Furthermore, although trauma centers routinely evaluate deaths within their hospital for preventability, few centers compare across regions, within the prehospital arena and even fewer have evaluated trauma deaths at non-trauma centers. Comprehensive population-based data on all trauma deaths within a defined region would provide a framework for effective prevention and intervention efforts at the regional and national levels. The authors adapted a military method recently used in Southwest Asia to determine the potential preventability of civilian trauma deaths occurring across a large and diverse population. The project design will allow a data-driven approach to improve services across the entire spectrum of trauma care, from prevention through rehabilitation.

Keywords: consensus panel; medicolegal autopsy; methods; preventable death rate; trauma.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram. IFS, Institute of Forensic Sciences.
Figure 2
Figure 2
Process of date flow. NP, non-preventable; P, preventable; PDR, preventable death rate; PP, potentially preventable.
Figure 3
Figure 3
System gaps after traumatic injury. EMR, Electronic Medical Record
See this image and copyright information in PMC

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