Trauma Registration in a Dutch Trauma Population with Emphasis on Quality of Care

We prospectively evaluated the care of all acutely trauma patients admitted to the St. Elisabeth Hospital, Tilburg, The Netherlands, during 3 consecutive years (1996 through 1998). Data were compiled in a physician operating round the clock available electronic medical record. A total of 2849 patients were included (60% male). More than 95% suffered from a blunt trauma. Out of 2849 admitted patients 115 died. Compared with the Major Trauma Outcome Study (MTOS), the survival rates revealed at St. Elisabeth Hospital suggest a negative difference (98.1% vs. 96%). However, evaluating population differences between MTOS and our population comparing survival probabilities based upon ISS/AIS (Injury Severity Score/Abbreviated Injury Score) and RTS (Revised Trauma Score), making comparison hazardous. The evaluation of our deceased patients showed that 56% of deaths is due to severe head injury, whereas 22% of the deceased patient population consisted of patients with femoral neck fractures and minimal physiological reserve. We conclude that TRISS (Trauma Injury Severity Score) method provides a good basis for evaluation of trauma care also in a non-US environment. However, due to population differences, care should be taken drawing overall conclusions. Obvious differences of results revealed at first sight should be submitted to further meticulous evaluation.