BACKGROUND: In Georgia, 21 hospitals are designated trauma centers in 2012, these hospitals reported trauma data to the Georgia Trauma Central Registry (GTCR). In 2013, the Georgia Trauma Commission (GTC) in collaboration with the Georgia Department of Public Health (DPH) implemented a new methodology (developed by Dr. E. Pracht, Associate Professor, University of South Florida, 2013) to identify all Georgia trauma patients seen in all 133 Georgia hospitals using the Georgia Hospital Discharge data (HD). As well as calculated the International Classification of Diseases Injury Severity Score (ICISS) for all HD trauma patients and compare to Injury Severity Score (ISS) as reported to the Georgia Trauma Central Registry (Gold Standard). A study was conducted to assess the completeness and accuracy of the newly implemented method using the 2012 Georgia HD data in comparison to the 2012 trauma data which had been reported to the GTCR.
METHODS: The 2012 HD recoded trauma cases from the 21 designated trauma hospitals were selected and linked to the GTCR true trauma cases reported by each of the designated centers by hospital ID, gender, date of birth, admission date, discharge date, discharge hour, and length of stay. Data were linked and analyzed using SAS 9.4. The analytical data set included recoded trauma patients with coded ICISS from HD and the ISS reported to the GTCR considered as the Gold Standard.
RESULTS: From the HD data 20,935 cases were coded as trauma cases; while 14,389 trauma cases were reported to the GTCR. Of these, 76% (10,887/14,389) cases were linked. The percent of linked cases varied by facility and hospital’s designation level. Among trauma cases that were linked, ninety-four percent (94%: 10,223/10,877) were true trauma cases based on GTCR (Gold Standard). Comparing the calculated ICISS from the HD data to the reported ISS in the GTCR data: only 64% of cases with coded severe ICISS had a severe ISS; 68% of cases with moderate ICISS had also a moderate or mild ISS; and 90% of cases with mild ICISS had a moderate or mild ISS.
CONCLUSIONS: Georgia HD data can be used to identify all trauma cases and trauma burden statewide, however using the ICISS might lead to misclassification of severe and moderate trauma cases. Further analysis should be conducted to assess the quality of ICISS in the Georgia HD data.