Hollander J E, Singer A J, Valentine S, Henry M C
Department of Emergency Medicine, University Medical Center, State University of New York Health Sciences Center, Stony Brook, USA.
Ann Emerg Med. 1995 May;25(5):675-85. doi: 10.1016/s0196-0644(95)70183-4.
More than 11 million patients with traumatic wounds are seen annually in emergency departments. We developed and validated a data registry for traumatic wounds treated in the ED.
Prospective, consecutive patient enrollment with a validation cohort of a convenience sample of 100 patients.
University-affiliated hospital ED.
For all patients with traumatic wounds requiring sutures, wound registry data sheets were completed at the time of initial visit using a closed-question format. Data recorded included demographic characteristics, time from injury to evaluation, pertinent medical history, wound characteristics, type of anesthesia, details of wound-cleansing methods, details of wound closure, and postoperative care. We devised a follow-up tool to evaluate for the presence of infection and short-term cosmetic appearance. Interphysician reliability was assessed for wound description, presence of infection, and cosmetic appearance by use of the kappa statistic.
A wound registry data collection instrument that takes less than 1 minute to complete and enables the collection of most wound management techniques used by emergency physicians was found to have substantial interobserver concordance for wound description (kappa range, .55 to .97), wound infection (kappa = 1.0) and overall cosmetic appearance (kappa = .61).
The wound registry is a reliable data collection instrument that is easy to use. It may be useful as a continuous quality-improvement tool or for standardization of wound surveillance and treatment data to facilitate future prospective studies in wound management.
急诊科每年接诊超过1100万例创伤伤口患者。我们开发并验证了一个用于登记急诊科治疗的创伤伤口的数据注册表。
前瞻性、连续纳入患者,并对100例便利样本患者组成的验证队列进行研究。
大学附属医院急诊科。
对于所有需要缝合的创伤伤口患者,在初次就诊时使用封闭式问题格式填写伤口注册表数据表。记录的数据包括人口统计学特征、受伤至评估的时间、相关病史、伤口特征、麻醉类型、伤口清洁方法的细节、伤口缝合的细节以及术后护理。我们设计了一种随访工具来评估感染情况和短期美容效果。通过kappa统计量评估不同医生之间在伤口描述、感染情况和美容效果方面的可靠性。
发现一种伤口注册表数据收集工具,完成时间不到1分钟,能够收集急诊医生使用的大多数伤口处理技术,在伤口描述(kappa范围为0.55至0.97)、伤口感染(kappa = 1.0)和整体美容效果(kappa = 0.61)方面具有较高的观察者间一致性。
伤口注册表是一种可靠且易于使用的数据收集工具。它可作为持续质量改进工具,或用于伤口监测和治疗数据的标准化,以促进未来伤口管理方面的前瞻性研究。