Identifying Pediatric Trauma Data Gaps at a Large Urban Trauma Referral Center in Santiago, Chile

Abstract

Background: Trauma registries contribute to improving trauma care, but their impact is highly dependent on the quality of the data. A simplified point of care pediatric trauma registry (PTR) was developed at the Centre for Global Surgery from the McGill University Health Centre (MUHC) for implementation in Low-middle income countries (LMICs). Pilot deployment was launched at a large urban trauma center in May 2016 in Santiago, Chile. Prior to deployment, we sought to identify missing data in existing trauma records in order to optimize PTR practicality and user benefit. Materials and methods:The project was approved by the local Institutional Review Board. Retrospective chart review was conducted on trauma patients below the age of 15 who were evaluated at the emergency room (ER) of Hospital Dr. Sotero del Rio (HSR) between January 1st and June 30th 2015. Data missingness was evaluated for each component of the PTR (demographics, mechanism, injury and outcomes). Potential independent predictors of data missingness were evaluated using multiple linear regression.Results: A total of 351 patients were included. Demographic data missingness ranged from 0% (age) to 95% (mode of arrival). Mechanism data missingness ranged from 6% (cause of injury) to 42% (site of injury). Injury physiology data missingness ranged from 37% (oxygen saturation) to 99% (respiratory rate). Interestingly, mean injury anatomy data missingness was significantly inferior to physiology data (0.6% vs. 78.6%, p < 0.05). Outcome data missingness reached 54% at 2 weeks. Conclusion:In resource-limited settings, high quality data is essential to guide responsible resource allocation. We believe implementation of a simplified trauma registry has the potential to reduce data gaps for pediatric trauma patients by streamlining trauma data collection at point of care. This should include streamlined data collection with a short per-patient completion time, and should forego attempts to collect data at 2 weeks, which has proven unsuccessful.