Annual Meeting of the Eastern Association for the Surgery of Trauma. Sanibel (USA), 1997/01/15.
Trauma registries are an essential but expensive tool for monitoring trauma system performance.
The time required to catalog patients'injuries is the source of much of this expense.
Typically, 15 minutes of chart review per patient are required, which in a busy trauma center may represent 25% of a full-time employee.
We hypothesized that International Classification of Disease-Ninth Revision (ICD-9) codes generated by the hospital information system (HI) would be similar to those coded by a dedicated trauma registrar (TR) and would be as accurate as TR ICD-9 codes in predicting outcome.
One thousand eight hundred twelve patients admitted to a Level I trauma center during 2 years had International Classification of Disease Injury Severity Scores (ICISS) calculated based on HI and TR ICD-9 codes.
The relative predictive powers of these two ICISSs were then compared for every patient using Receiver Operator Characteristic Curve Area (ROC) and Hosmer Lemeshow Statistics.
Eighty-nine percent of patients (1,608 of 1,812) had identical HI and TR ICISSs.
Eleven patients'ICISSs differed by>0.1, and only two patients'scores differed by>0.2. ICISS proved to be a powerful predictor of outcome whether derived from HI (ROC=0.884 ; 95% confidence interval (CI)=0.850-0.917) or TR (ROC=0.872 ; 95% Cl=0.837-0.908).
Although these predictive powers were not significantly different (p=0.076), the trend was for HI to perform better than TR. (...)
Mots-clés Pascal : Traumatisme, Evaluation, Indice gravité, Relation, Evolution, Intérêt, Codage, Valeur prédictive, Coût, Etude statistique, Homme, Organisation santé, Economie santé
Mots-clés Pascal anglais : Trauma, Evaluation, Severity score, Relation, Evolution, Interest, Coding, Predictive value, Costs, Statistical study, Human, Public health organization, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0484855
Code Inist : 002B16N. Création : 03/02/1998.