The Development of a Regional Trauma Registry

Abstract

International standards of care in the trauma patient have recognized the importance of trauma registries across continents. Modern systems require modern datasets, which have to be uniform, compatible and interlinked. A regional trauma registry was developed in Lombardy thanks to the collaboration of all parties involved in trauma care, from field workers to rehabilitation professionals.

Appendix: Birth of the Utstein Style

The Utstein style was born in the early 1990s in conjunction with the growing interest in the management and prevention of cardiac arrest. In June 1991, at a meeting at the historic Utstein Abbey on the island of Mosterøy in Norway, representatives of the American Heart Association (AHA), European Resuscitation Council (ERC), Heart and Stroke Foundation of Canada (HSFC), and Australian Resuscitation Council defined the general rules for the collection of data relating to cardiopulmonary resuscitation (CPR) carried out in an out-of-hospital setting. This set of rules took the name of Utstein style. It was the first step that established the now universally accepted standards for data collection in and out of the hospital environment. A flow chart was designed to define a data recording method for the creation of a database, with the aim of evaluating the epidemiology of cardiac arrest episodes and the resulting responses to CPR maneuvers. This new organization of the cardiac arrest database was considered the cornerstone on which to base the development and improvement of the care chain also in other areas, such as that concerning serious trauma [19, 20].

To this end and in order to reach a European agreement, the various trauma management organizations (Scandinavian Networking Group for Trauma and Emergency Management, UK Trauma Audit and Research Network, DGU-TR, and RITG) convened at a symposium in 2007 in order to draft an Utstein style template to standardize the reporting of data on severe trauma [21]. An attempt was therefore made to create a registry that was as compatible as possible with the main Trauma Registries in Europe and that adhered to the EuroTARN program for the development of a European Trauma Registry, with the aim of promoting the development of a continental model for the prediction of outcome allowing international monitoring of severe trauma. In 2008 some authors further reviewed the criteria and parameters for the registration of trauma [21]; this revision led to the definition of the guidelines that are currently followed by the Lombardy Trauma Registry.