医疗机构在向国家创伤数据库报告合并症方面的差异。
Facility disparities in reporting comorbidities to the National Trauma Data Bank.
机构信息
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
Am J Surg. 2018 Sep;216(3):401-406. doi: 10.1016/j.amjsurg.2018.01.031. Epub 2018 Feb 1.
BACKGROUND
The National Trauma Data Bank (NTDB) includes patient comorbidities. This study evaluates factors of trauma centers associated with higher rates of missing comorbidity data.
METHODS
Proportions of missing comorbidity data from facilities in the NTDB from 2011 to 2014 were evaluated for associations with facility characteristics. Proportional impact analysis was performed to identify potential policy targets.
RESULTS
Of 919 included facilities, 85% reported comorbidity data in 95% or more cases; only 31.3% were missing no data. Missing rates were significantly different based on most facility categories, but independently associated only with hospital size, region, and trauma center level. Only 15% of centers were responsible for over 80% of cases missing data.
CONCLUSIONS
There is significant nonrandom variation in reporting trauma patient comorbidities to the NTDB. Missing data needs to be recognized and considered in studies of trauma comorbidities. Targeted intervention may improve data quality.
背景
国家创伤数据库（NTDB）包含患者合并症信息。本研究评估了与更高的合并症数据缺失率相关的创伤中心因素。
方法
评估了 NTDB 中 2011 年至 2014 年各机构的合并症数据缺失比例与机构特征之间的关联。进行比例影响分析以确定潜在的政策目标。
结果
在 919 个纳入的机构中，85%的机构报告了 95%或以上病例的合并症数据；只有 31.3%的机构没有数据缺失。缺失率基于大多数机构类别存在显著差异，但仅与医院规模、地区和创伤中心级别独立相关。只有 15%的中心负责超过 80%的病例缺失数据。
结论
向 NTDB 报告创伤患者合并症存在显著的非随机变异。在研究创伤合并症时，需要认识到并考虑数据缺失的问题。有针对性的干预措施可能会提高数据质量。
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