The Role of Trauma Registries in the
Development of Guidelines: A European Perspective
Manchester 6th November 2002
from Discussion Groups
Raporteurs: Claus Falk Larsen & Murray Mackay
Should we have a European Trauma Registry?
All delegates agreed to the aspirational principle of a European
Trauma Registry but tempered with an evolutionary approach.
It was suggested that the Registry would be used to propagate
best practice in quality of care, epidemiological research
and prevention of injury.Aims and objectives should be clearly
stated. Quality and validated data is central.
with ‘working databases’ should be encouraged
now to compare processes of care and outcomes.
It was noted that there are differences in inclusion criteria
A population overview would be most beneficial nevertheless
well defined subgroups are essential. These would include
pre-hospital deaths, different groups of patients dependent
on ISS or Length of Stay or mechanism and intent or if Trauma
Teams are / are not present. If organised in modules (current
criteria) comparative work may be undertaken.
It was concluded that this may be a capacity question and
therefore there should be an ALL inclusive criteria with different
AIS should be the base standard and an electronic
version on Registries is essential.
Elaine Wodzin agreed to discuss this issue with AAAM at a
meeting week beginning 11th November. It is essential that
injury descriptions are retained on a Registry not just the
Absolute physiological recordings are also essential and not
merely the TRISS codes.
and NISS require more research and validation and the statisticians
agreed that there was not much advantage in the use of NISS
over ISS when evaluating population comparisons. Agreement
that all coding should be carried out by trained and qualified
coders with access to clinical support.
ASCOT was not discussed at this time.
30 day length of stay or discharge was agreed.
Disability assessments are necessary but require discussions
and will be resource dependant. A combination of detailed
(POLO*), ‘easier to collect’ (EQ5D) and the Functional
Capacity Index (to be used in future AIS Dictionaries) may
be required. A validation site for the Functional Capacity
Index in Europe may also be required. The overall aim should
be for a generic and specific health status instrument.
The POLO Chart consists of Glasgow Outcome Scale, patient
interviews SF36, self reporting Euroquol and a validation
study which has been done two years after injury.
The proceedings of the European conference on disability are
reported in the Journal of
Restorative Neurology and Neuroscience 2002
Should we have performance measures?
Agreed in principle. Correct application is essential
and it would appear that Registries do vary. There would be
consequences on the logistic regression coefficients and models.TRISS
to be used in the interim but research into improvements are
In the absence of funding, a Virtual Registry was suggested.
Each country to have a ‘Centre’ that would liase
Should be a minimum dataset and agreements would be required.
/ Confidentiality / Ethics
Anonymised data.An objective system involving other organisations
should act on poor performance.
It was thought that a Core Dataset would strengthen any bids
for moving forward?
- TARN will set up an Internet Communication Area:
- The details of the European Group will be posted on the
Internet Area: 20th December
- The Aims and Objectives (Mission Statement) of the European
Group to be ‘posted’ on the Internet Area. Should
include short term, medium term and long term goals. All members
of the group will be notified of the internet address by e-mail:
Agreement on a minimum dataset through a DELPHI process using
an Internet based discussion. 31st March
Review and include the European Emergency Medicine and Public