Medeiros-de-Souza Ana Cláudia, Sinhori Lopes Luana Emanuelly, Felicissimo Gomes de Souza Bandeira Tayna, Reis Correia Lucas, Bandeira de Sá Naiza Nayla, Zocca de Oliveira Bruno
Hospital Israelita Albert Einstein, 755 Comendador Elias Jafet Street, L1 Floor, Room 134, São Paulo, 05653-000, Brazil.
Department of Preventive Medicine, University of São Paulo, São Paulo, Brazil.
JMIR Public Health Surveill. 2025 Sep 10;11:e67115. doi: 10.2196/67115.
The Brazilian project, launched in 2021, aims to establish a nationwide injury registry that systematically collects detailed information on incidents and individuals across the country, regardless of injury severity. The registry integrates information from prehospital and hospital care, various health systems lacking interoperability, and data from sectors such as firefighters and police. Its primary aim is to enhance health surveillance by providing timely, high-quality information that guides prevention strategies and informs policymaking. In addition, the project seeks to reduce morbidity and mortality associated with injuries.
This study aimed to investigate the effects of injury registry data on policymaking, hospitalization rates or duration, and mortality.
The systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a protocol registered in PROSPERO (International Prospective Register of Systematic Reviews, CRD42023481528). A total of 5 databases were searched in November 2023, with an update conducted in March 2024, incorporating reference lists from the studies included. Two reviewers independently screened records, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale, resolving disagreements with a third reviewer. Studies were eligible if they reported results related to the implementation and use of injury or trauma registry data for at least one outcome of interest, while those based on other sources were excluded. Synthesis of findings was presented in tables, and the observed results were reported as number or percentage differences.
Out of 9100 studies retrieved, 3951 were excluded due to duplication, leaving 5149 for selection, with 15 full texts reviewed. Only 5 studies met the inclusion criteria, highlighting a notable scarcity of research on the effects or results of registry data on injury outcomes. It is important to note that the studies included reflect correlations rather than causalities, and there are currently no publications on impact. The findings suggest that injury and trauma registries have the potential to inform policymaking, which can lead to enhanced health outcomes. One study noted a 3-day reduction in intensive care unit stay (from 16 to 13 days; P<.05) and a 4% reduction in expected hospital mortality (from 17.5% to 21.5%) for patients with an Injury Severity Score ≥16, while another showed a 42% annual decrease in traffic injury hospital admissions (from 45 to 16). Significant methodological heterogeneity and the small number of studies limited the feasibility of a meta-analysis.
Establishing an injury registry in Brazil presents a significant opportunity to enhance health outcomes through informed policymaking. While it is crucial to set appropriate expectations regarding its effects on morbidity and mortality, particularly concerning the causality and transportability of the findings to the Brazilian context, its role in facilitating preventive measures and improving surveillance capabilities remains valuable.
巴西于2021年启动的项目旨在建立一个全国性伤害登记系统，该系统能系统地收集全国范围内有关事故及个人的详细信息，无论伤害严重程度如何。该登记系统整合了院前和医院护理的信息、缺乏互操作性的各种卫生系统以及消防员和警察等部门的数据。其主要目标是通过提供及时、高质量的信息来加强健康监测，这些信息可指导预防策略并为政策制定提供依据。此外，该项目旨在降低与伤害相关的发病率和死亡率。
本研究旨在调查伤害登记数据对政策制定、住院率或住院时长以及死亡率的影响。
本系统评价遵循PRISMA（系统评价和Meta分析的首选报告项目）指南，研究方案已在PROSPERO（国际系统评价前瞻性注册库，CRD42023481528）中注册。2023年11月共检索了5个数据库，并于2024年3月进行了更新，纳入了所纳入研究的参考文献列表。两名评审员独立筛选记录、提取数据，并使用纽卡斯尔 - 渥太华量表评估方法学质量，如有分歧则与第三名评审员协商解决。若研究报告了与伤害或创伤登记数据的实施和使用相关的至少一项感兴趣结果，则该研究符合纳入标准，而基于其他来源的研究则被排除。研究结果以表格形式呈现，观察结果以数值或百分比差异报告。
在检索到的9100项研究中，3951项因重复而被排除，剩余5149项供筛选，其中15篇全文被评审。只有5项研究符合纳入标准，这凸显了关于登记数据对伤害结果的影响或结果的研究明显匮乏。需要注意的是，所纳入的研究反映的是相关性而非因果关系，目前尚无关于影响的出版物。研究结果表明，伤害和创伤登记系统有潜力为政策制定提供信息，进而改善健康结果。一项研究指出，对于损伤严重程度评分≥16的患者，重症监护病房住院时间缩短了3天（从16天降至13天；P<0.05），预期医院死亡率降低了4%（从17.5%降至21.5%），而另一项研究显示交通伤住院人数每年下降42%（从45例降至16例）。显著的方法学异质性和研究数量较少限制了Meta分析的可行性。
在巴西建立伤害登记系统为通过明智的政策制定改善健康结果提供了重大机遇。虽然对于其对发病率和死亡率的影响设定适当预期至关重要，特别是关于研究结果在巴西背景下的因果关系和可转移性，但它在促进预防措施和提高监测能力方面的作用仍然很有价值。
