Edwards Antoinette, Di Bartolomeo Stefano, Chieregato Arturo, Coats Tim, Della Corte Francesco, Giannoudis Peter, Gomes Ernestina, Groenborg Henrik, Lefering Rolf, Leppaniemi Ari, Lossius Hans Morten, Ortenwal Per, Roise Olav, Rusnak Martin, Sturms Leontien, Smith Martin, Bondegaard Thomsen Annemarie, Willett Keith, Woodford Maralyn, Yates David, Lecky Fiona
University of Manchester, Trauma Audit & Research Network, Clinical Sciences Building, Hope Hospital, Salford, Greater Manchester M6 8HD, United Kingdom.
Resuscitation. 2007 Nov;75(2):286-97. doi: 10.1016/j.resuscitation.2007.06.023. Epub 2007 Aug 21.
Trauma management systems have grown in response to regional variations in trauma population, geographical conditions and the provisions of care. National Trauma Registries are being established to improve patient outcomes. However international comparisons could provide the potential to record regional performance, identify and share examples of best practice. To assess whether it was possible to compare data currently being collected by a number of trauma services across Europe, a group was established to develop a common core dataset and to assess the feasibility of collecting anonymised data.
A series of meetings with European collaborators led to the creation of a group entitled EuroTARN. A website was developed in 2002 and interested parties were invited to submit suggestions for a European dataset using an online version of the Delphi technique. A core dataset was created in 2003 and in 2004 participants were invited to submit a summary of past cases online via the EuroTARN Website.
Representatives from 14 countries met and corresponded to create the core dataset. During a trial data collection phase 14 institutions from 11 countries submitted unadjusted mortality data for over 21,500 cases with injury severity Scores of over 15 including information on multiply injured and head injured patients. The results demonstrated that there were observed differences in trauma outcome for similar groups of patients.
It is possible to collect and collate outcome data from established trauma registries across Europe with minimal additional infrastructure using a web-based system. Initial analysis of the results reveals significant international variations. The network has potential as a source of data for epidemiological and clinical research and for optimal trauma system design across Europe.
创伤管理系统已随着创伤人群的区域差异、地理条件和护理服务的提供而发展。各国正在建立创伤登记处,以改善患者治疗效果。然而,国际比较有可能记录区域表现,识别并分享最佳实践案例。为评估是否有可能对欧洲多个创伤服务机构目前收集的数据进行比较,成立了一个小组来制定一个通用核心数据集,并评估收集匿名数据的可行性。
与欧洲合作者举行了一系列会议,促成了一个名为欧洲创伤审计与研究网络(EuroTARN)的小组的成立。2002年创建了一个网站,并邀请相关方使用德尔菲技术的在线版本为欧洲数据集提交建议。2003年创建了一个核心数据集,2004年邀请参与者通过EuroTARN网站在线提交过去病例的摘要。
来自14个国家的代表会面并通信,创建了核心数据集。在试验数据收集阶段,来自11个国家的14个机构提交了21500多例损伤严重程度评分超过15分的病例的未调整死亡率数据,包括多发伤和头部受伤患者的信息。结果表明,相似患者群体的创伤结局存在观察到的差异。
使用基于网络的系统,只需最少的额外基础设施,就有可能从欧洲各地已有的创伤登记处收集和整理结局数据。对结果的初步分析揭示了显著的国际差异。该网络有潜力作为欧洲流行病学和临床研究以及优化创伤系统设计的数据来源。