Phillips Bart, Clark David E, Nathens Avery B, Shiloach Mira, Freel Andrew C
Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, Illinois, USA.
J Trauma. 2008 Mar;64(3):768-79; discussion 779-80. doi: 10.1097/TA.0b013e3181620152.
Administrative and registry databases are useful for researchers given their availability and size, yet their limitations for specific applications remain undefined. We compared injury records from a large administrative database and the National Trauma Data Bank (NTDB) with the goal of furthering the understanding of their respective limitations.
The study hospitals had submitted records to both the NTDB and the Nationwide Inpatient Sample (NIS) for patients admitted during 2002. Record inclusion criteria for comparison included nonelective admissions with a primary diagnosis of injury (excluding isolated hip fractures). Numbers of cases and variables common to both databases were compared.
Twenty-four hospitals had records both in the NTDB (24,619 records) and in the NIS (25,586 records). We found less missing cost and payer information in the NIS compared with the NTDB (0% and 0.1% vs. 30.5% and 24%, respectively), higher mean number of comorbidities per record in the NIS (0.77 vs. 0.18), and a lower crude case fatality rate in the NIS (3.5% vs. 5.2%).
The main differences between the databases reflected the different motives for data collection and the inclusion or exclusion criteria imposed by trauma registries. These differences require consideration when using either database to investigate injury-related questions.
行政数据库和注册数据库因其可用性和规模对研究人员很有用，但它们在特定应用中的局限性仍不明确。我们比较了一个大型行政数据库和国家创伤数据库（NTDB）中的损伤记录，目的是进一步了解它们各自的局限性。
研究医院已将2002年期间收治患者的记录提交给NTDB和全国住院患者样本（NIS）。用于比较的记录纳入标准包括非选择性入院且主要诊断为损伤（不包括单纯性髋部骨折）。比较了两个数据库共有的病例数和变量。
24家医院在NTDB（24,619条记录）和NIS（25,586条记录）中均有记录。我们发现，与NTDB相比，NIS中缺失的费用和支付方信息较少（分别为0%和0.1%对30.5%和24%），NIS中每条记录的合并症平均数量较高（0.77对0.18），NIS中的粗病死率较低（3.5%对5.2%）。
数据库之间的主要差异反映了数据收集的不同动机以及创伤登记处规定的纳入或排除标准。在使用任一数据库调查与损伤相关的问题时，都需要考虑这些差异。
