National Trauma Registry of Iran: A Pilot Phase at a Major Trauma Center in Tehran.

BACKGROUND: The main objective was to describe the results of the pilot phase of the national trauma registry of Iran (NTRI) at a referral university trauma center in Tehran. METHODS: The study was performed at Sina Hospital in Tehran, Iran from August 1 to September 30, 2016. Patients who had the NTRI criteria were included. 109 data variables were analyzed including demographics, medical care information, injury characteristics, and outcomes. RESULTS: Over 2 months, 171 patients, predominantly males (87.1%) with an average age of 37.2 (±19.5) years were registered. The most common mechanism of injury was road traffic crash (RTC) (53.2%), followed by fall (21.1%) and penetrating injuries (18.7%). RTC represented a remarkable proportion of the injuries with higher injury severity score (ISS) (P = 0.046). The mean hospital length of stay (LOS) was 9.8 (±12.2) days. There were significant relationships between Glasgow Coma Scale (GCS) (P = 0.03), drug abuse (P = 0.05), and ISS (P = 0.008) as independent variables and LOS. 21.6% of the patients were admitted to ICU, with a larger proportion of fall injuries (44.4%) (P = 0.002). Eight patients (4.7%) died during hospitalization, of which 7 cases were male. There was significant association between increasing age and ISS with death outcome. CONCLUSION: After successful implementation of NTRI at a major trauma center in Tehran, RTC was identified as the main cause of admission. Most patients were young men. The mean time interval between injury occurrence and hospital admission was too long. These findings could be used to improve quality of trauma care and formulate targeted preventive strategies.

Feasibility and Data Quality of the National Spinal Cord Injury Registry of Iran (NSCIR-IR): A Pilot Study.

BACKGROUND: Spinal cord injury (SCI) is one of the most disabling consequences of trauma with unparalleled economic, social, and personal burden. Any attempt aimed at improving quality of care should be based on comprehensive and reliable data. This pilot investigation studied the feasibility of implementing the National Spinal Cord and Column Injury Registry of Iran (NSCIR-IR) and scrutinized the quality of the registered data. METHODS: From October 2015 to May 2016, over an 8-month period, 65 eligible trauma patients who were admitted to hospitals in three academic centers in mainland Iran were included in this pilot study. Certified registered nurses and neurosurgeons were in charge of data collection, quality verification, and registration. RESULTS: Sixty-five patients with vertebral column fracture dislocations were registered in the study, of whom 14 (21.5%) patients had evidence of SCI. Mechanisms of injury included mechanical falls in 30 patients (46.2%) and motor vehicle accidents in 29 (44.6%). The case identification rate i.e. clinical and radiographic confirmation of spine and SCI, ranged from 10.0% to 88.9% in different registry centers. The completion rate of all data items was 100%, except for five data elements in patients who could not provide clinical information because of their medical status. Consistency i.e. identification of the same elements by all the registrars, was 100% and accuracy of identification of the same pathology ranged from 66.6% to 100%. CONCLUSIONS: Our pilot study showed both the feasibility and acceptable data quality of the NSCIR-IR. However, effective and successful implementation of NSCIR-IR data use requires some modifications such as presence of a dedicated registrar in each center, verification of data by a neurosurgeon, and continuous assessment of patients' neurological status and complications.