Elsevier

Injury

Volume 44, Issue 6, June 2013, Pages 713-721
Injury

Review
Trauma registries in developing countries: A review of the published experience

https://doi.org/10.1016/j.injury.2013.02.003Get rights and content

Abstract

Background

The burden of injury is greatest in developing countries. Trauma systems have reduced mortality in developed countries and trauma registries are known to be integral to monitoring and improving trauma care. There are relatively few trauma registries in developing countries and no reviews describing the experience of each registry. The aim of this study was to examine the collective published experience of trauma registries in developing countries.

Methods

A structured review of the literature was performed. Relevant abstracts were identified by searching databases for all articles regarding a trauma registry in a developing country. A tool was used to abstract trauma registry details, including processes of data collection and analysis.

Results

There were 84 articles, 76 of which were sourced from 47 registries. The remaining eight articles were perspectives. Most were from Iran, followed by China, Jamaica, South Africa and Uganda. Only two registries used the Injury Severity Score (ISS) to define inclusion criteria. Most registries collected data on variables from all five variable groups (demographics, injury event, process of care, injury severity and outcome). Several registries collected data for less than a total of 20 variables. Only three registries measured disability using a score. The most commonly used scores of injury severity were the ISS, followed by Revised Trauma Score (RTS), Trauma and Injury Severity Score (TRISS) and the Kampala Trauma Score (KTS).

Conclusion

Amongst the small number of trauma registries in developing countries, there is a large variation in processes. The implementation of trauma systems with trauma registries is feasible in under-resourced environments where they are desperately needed.

Section snippets

Background

The global burden of injury is huge and growing, particularly in low- and middle-income countries (LMICs).1 Access to quality trauma care is critical to reducing mortality and disability from injury.1, 2 In high-income countries (HICs), the introduction of systems of trauma care has led to a reduction in mortality and disability.3, 4, 5

Whilst LMICs suffer the greatest burden of injury, access to quality trauma care is, overall, less than in HICs.1, 2 This paradox has been recognised by

Methods

A structured review of the literature was performed. Relevant abstracts were identified by searching the following databases on 3 May 2011: MEDLINE, Embase and CINAHL. There were no date or language restrictions placed on the search. Key words employed in the search were: “trauma registry”, “trauma registries”, “trauma database*”, “trauma databank*”, “injury registry”, “injury registries”, “injury database*”, and “injury databank*”. An additional subject heading search was performed in MEDLINE

Results

The literature search initially returned 385 articles. Application of the inclusion criteria defined above led to the identification of 84 eligible journal articles available in full text English language.11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84

Discussion

This review has brought together the collective published experience of trauma registries in developing countries. It has utilised a prospectively developed tool to describe and analyse the features of trauma registries in developing countries. The review has demonstrated that the majority of trauma registry publications from developing countries have originated from a relatively small number of such countries. Specifically, amongst developing countries as defined by the UN Human Development

Conclusion

From developing countries, there have been less than 100 trauma registry publications in the medical literature covering less than 50 registries across just 21 countries. Most of these registries do not use ISS-based inclusion criteria, collect data from across all variable groups, including pre-hospital information, ED vital signs and survival, and focus only upon questions of epidemiology. Few trauma registries use scores of disability. Several trauma registries collect data on less than 20

Conflict of interest statement

There are no known or perceived conflicts of interest. There were no sources of funding for this study.

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    Source of work: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Monash University (Alfred Campus), Commercial Road, Melbourne, 3004, Australia.

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