Injury registration for primary prevention in a provincial Russian region: setting up a new trauma registry

Abstract

Background The Shenkursk Injury Registry (SHIR) was established in the Shenkursk District, Northwestern Russia in 2015 for the purposes of primary prevention. The SHIR covers all injuries (ICD-10 diagnoses from S00 to T78) for which medical aid is given at the Shenkursk central district hospital and includes data about injury circumstances. We used the SHIR data to assess the quality of the SHIR as an evidence basis and for the local preventive applications. Methods Completeness, representativeness, and reliability of the SHIR data were assessed using a sample of 1696 injuries which have occurred in July 2015–June 2016. Chi-square tests were used to assess differences between the registered and missed cases in the registry and Cohen’s kappa were applied to assess the agreement between independent data entries. Results The completeness of the SHIR with respect to the coverage of cases treated at the Shenkursk central district hospital was 86%. There were no differences between the registered and the missed injuries by sex, ICD-10 codes, weekday of admission, but there were differences in their distribution by attending physicians. Also, higher proportions of child injuries and injuries in the summer time were among the missed cases. Signs of lower injury severity (different distribution by ICD-10 codes and lower proportion of traffic injuries) were observed among injuries in rural areas which were not covered by the registry because of treatment at rural primary health care units without referrals to the central hospital. Two independent data entries from standard paper injury registration forms showed a 79–99% agreement, depending on the variable considered. Conclusion With consideration of possible insubstantial overestimates of the average injury severity, the SHIR data can be considered sufficiently complete, reliable, and representative of the injury situation in the Shenkursk District. Therefore, SHIR is an adequate evidentiary basis for planning local injury prevention.

Mechanisms of accidental fall injuries and involved injury factors: a registry-based study

“…Another methodological consideration is completeness of the SHIR with respect to the coverage of cases treated at the CDH. According to our estimates (Unguryanu et al 2019), this completeness was 86%. There were no substantial differences between registered and missed injuries in the SHIR by sex, weekday of admission, diagnostic and external cause categories, but missed cases had insubstantially higher proportions of child injuries and injuries in summer time (Unguryanu et al 2019).…”

“…According to our estimates (Unguryanu et al 2019), this completeness was 86%. There were no substantial differences between registered and missed injuries in the SHIR by sex, weekday of admission, diagnostic and external cause categories, but missed cases had insubstantially higher proportions of child injuries and injuries in summer time (Unguryanu et al 2019). However, as the proportion of missed injuries in the SHIR was small and the missed cases were similar to the registered ones, the imperfect completeness of the SHIR should not considerably affect its representativeness for total injuries as well as fall injuries treated at the CDH.…”

“…If a patient does not complete the IRF due to a severe condition or other reasons (about 40% of cases), injury registrars (two trained nurses) complete the form retrospectively, using data from routine medical records (ambulance journal, outpatient medical card, case history) as well as information obtained from the attending physician. A more detailed description of the SHIR, the IRF, and methodological considerations are presented elsewhere (Unguryanu et al 2019;Unguryanu et al 2017).…”

“…The SHIR includes injuries which are treated at the Shenkursk CDH only. Based on our earlier study of completeness, representativeness, and reliability of the SHIR data (Unguryanu et al 2019), 56% of all injuries in the district occur in rural areas, and 42% of the rural injuries are treated at primary care units. This means that about 20% of total injuries in the district are not treated in the CDH and, therefore, are not covered by the SHIR.…”

“…The Shenkursk Injury Registry (SHIR) is a populationbased registry that was established in the Shenkursk District, Northwestern Russia in 2015 for the purposes of primary prevention (Unguryanu et al 2019), and it shows that falls are the most common injury mechanism in the area. Using data from the SHIR, we studied the circumstances of accidental fall injuries (hereafter referred to as fall injuries) by age to provide data-driven evidence for development of preventive strategies.…”