First step toward a better trauma management: Initial results of the Northern Izmir Trauma Registry System for children

Background: Trauma is an important health problem in children, and improvement in national trauma care is only possible through the knowledge gathered from trauma registry systems. This information is not available in our country, because there is no current trauma registry system at the hospitals. Our aim is to explain the trauma registry system we have developed and present the first year's data.
Methods: The planned trauma registry system was integrated into the emergency department registry system of 14 hospitals in Izmir province. The data of pediatric multiple trauma patients have been recorded automatically through the registry system. Demographics, vital signs, mechanism, type of trauma, anatomical region, ISS, PTS, GCS, length of hospital stay and need for blood transfusion/endotracheal intubation/surgery/hospitalization were evaluated by patient transfer status and outcome.
Results: At the end of one year, a total of 356 pediatric major trauma patients were included in the study. The most common type of trauma was blunt trauma (91.9%) and the mechanism was vehicle-related traffic accidents (28.1%). In the group with the worse outcome than the Glasgow outcome score, age was greater, ISS was higher and PTS was lower. Motorcycle accidents, sports injuries, and penetrating injuries were more frequent in this group. All the scales were significantly different between direct and transferred patients. The referral time to the hospital of the transferred patients were longer than directly admitted patients, but the results were not different.
Conclusion: Pediatric major trauma is an important cause of mortality and morbidity, and our trauma registry system, which is a successful example abroad, is not enough in the country. We hope that the trauma registry system we planned and started the pilot application will be expanded to include other hospitals throughout the country with the aim of developing a national registry system.
Key words: Pediatric trauma, major trauma, trauma registry, trauma system

Çocuklarda daha iyi travma yönetimi için ilk adým: Kuzey Ýzmir Travma Kayýt Sistemi’nin ilk sonuçlarý

BACKGROUND: Trauma is an important health problem in children, and improvement in trauma care on the national level is possible only through the knowledge gathered from trauma registry systems. This information is not available in our country, because there is no current trauma registry system in the hospitals. Our aim in this paper is to explain the trauma registry system we have developed and to present the first year’s data.
METHODS: The planned trauma registry system was integrated into the emergency department registry system of 14 hospitals in the Izmir province. The data of pediatric patients with multiple trauma have been recorded automatically through the registry system. Demographics, vital signs, mechanism, the type of trauma, anatomical region, Injury Severity Score (ISS), Pediatric Trauma Score (PTS), Glasgow Coma Scale (GCS) score, the length of hospital stay, and the need for blood transfusion/endotracheal intubation/surgery/hospitalization were evaluated by the patient transfer status and outcome.
RESULTS: At the end of one year, a total of 356 pediatric major trauma patients were included in the study. The most common type of trauma was blunt trauma (91.9%), and the most common mechanism was vehicle-related traffic accident (28.1%). In the group with the Glasgow Outcome Scale ≤3; the age was greater, ISS was higher, and PTS was lower. Motorcycle accidents, sports injuries, and penetrating injuries were more frequent in this group. All scores were significantly different between direct and transferred patients. The referral time to the hospital of the transferred patients was longer than directly admitted patients, but the results were not different.
CONCLUSION: Pediatric major trauma is an important cause of mortality and morbidity, and our trauma registry system, which is a successful example abroad, is insufficient in our country. We hope that the trauma registry system we planned and the pilot application we started will be expanded to include other hospitals throughout the country with the aim of developing a national registry system.