Naghdi Khatereh, Azadmanjir Zahra, Saadat Soheil, Abedi Aidin, Koohi Habibi Sahar, Derakhshan Pegah, Safdarian Mahdi, Abdollah Zadegan Shayan, Amirjamshidi Abbas, Sharif-Alhoseini Mahdi, Arab Kheradmand Jalil, Mohammadzadeh Mahdi, Zendehdel Kazem, Khazaeipour Zahra, Hashemi Seyed Mahmood Ramak, Saberi Hooshang, Karimi Yarandi Kourosh, Ketabchi Seyed Ebrahim, Yousefzadeh-Chabok Shahrokh, Heidari Hamid, Sotodeh Arezo, Pestei Khalil, Ghodsi Zahra, Sadeghian Farideh, Noonan Vanessa, Benzel Edward C, Oreilly Gerard, Chapman Jens, Hagen Ellen Merete, Fehlings Michael G, Vaccaro Alexander R, Faghih Jooybari Morteza, Zarei Mohammad Reza, Zafarghandi Mohammad Reza, Salamati Payman, Nezareh Saeed, Khormali Moein, Sadeghi-Naini Mohsen, Jazayeri Seyed Behzad, Aarabi Bizhan, Rahimi-Movaghar Vafa
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2017 Aug;20(8):494-502.
Spinal cord injury (SCI) is one of the most disabling consequences of trauma with unparalleled economic, social, and personal burden. Any attempt aimed at improving quality of care should be based on comprehensive and reliable data. This pilot investigation studied the feasibility of implementing the National Spinal Cord and Column Injury Registry of Iran (NSCIR-IR) and scrutinized the quality of the registered data.
From October 2015 to May 2016, over an 8-month period, 65 eligible trauma patients who were admitted to hospitals in three academic centers in mainland Iran were included in this pilot study. Certified registered nurses and neurosurgeons were in charge of data collection, quality verification, and registration.
Sixty-five patients with vertebral column fracture dislocations were registered in the study, of whom 14 (21.5%) patients had evidence of SCI. Mechanisms of injury included mechanical falls in 30 patients (46.2%) and motor vehicle accidents in 29 (44.6%). The case identification rate i.e. clinical and radiographic confirmation of spine and SCI, ranged from 10.0% to 88.9% in different registry centers. The completion rate of all data items was 100%, except for five data elements in patients who could not provide clinical information because of their medical status. Consistency i.e. identification of the same elements by all the registrars, was 100% and accuracy of identification of the same pathology ranged from 66.6% to 100%.
Our pilot study showed both the feasibility and acceptable data quality of the NSCIR-IR. However, effective and successful implementation of NSCIR-IR data use requires some modifications such as presence of a dedicated registrar in each center, verification of data by a neurosurgeon, and continuous assessment of patients' neurological status and complications.
脊髓损伤（SCI）是创伤最致残的后果之一，带来了无与伦比的经济、社会和个人负担。任何旨在提高护理质量的尝试都应基于全面可靠的数据。这项初步调查研究了实施伊朗国家脊髓和脊柱损伤登记处（NSCIR-IR）的可行性，并审查了登记数据的质量。
在2015年10月至2016年5月的8个月期间，这项初步研究纳入了伊朗大陆三个学术中心医院收治的65名符合条件的创伤患者。经认证的注册护士和神经外科医生负责数据收集、质量核查和登记。
研究中登记了65例脊柱骨折脱位患者，其中14例（21.5%）有脊髓损伤证据。损伤机制包括30例（46.2%）机械性跌倒和29例（44.6%）机动车事故。病例识别率，即脊柱和脊髓损伤的临床及影像学确认率，在不同登记中心为10.0%至88.9%。除了因病情无法提供临床信息的患者的五个数据元素外，所有数据项的完成率为100%。一致性，即所有登记员对相同元素的识别率，为100%，相同病理的识别准确率为66.6%至100%。
我们的初步研究表明NSCIR-IR既具有可行性，数据质量也可接受。然而，要有效且成功地使用NSCIR-IR数据，需要进行一些改进，例如每个中心要有专门的登记员，由神经外科医生核查数据，以及持续评估患者的神经状态和并发症。
