The History of Trauma Registry
The Committee on Trauma and the Committee on Shock of the National Academy of Sciences and the National Research Council released a “white paper” in 1966 entitled “Accidental Death and Disability: The Neglected Disease of Modern Society”. This paper is the first to recognize the need for a trauma registry as well as publish recommendations.
Here is an excerpt from that paper.
“Emergency case records are often inadequate. Sufficient thought has not been given to extracting information concerning the nature of the accident, the clinical condition during transportation and at the time of entry to the emergency department, the resuscitative measures used, the response of the patient, the initial laboratory and X-ray records, and, finally, the ultimate outcome with or without temporary or permanent disability. This information is vital on several scores. It is essential in recreating the circumstances of the accident and in relating the mechanism of trauma to accident prevention. It is necessary for clinical analysis, for improvement of therapy, and for appraisal of emergency facilities. Finally, it could provide a basis for determining the duration, nature and degree of disability and the long-term, natural history of specific injuries.…Information of this type on a broad scale could be obtained by the development of trauma registries within the hospital, similar to those established and maintained for many years in the cancer field. The vast pool of information available from such registries might provide guidelines for more objective definition of degrees of disability on which to base judgment in compensation cases.
Recommendations:
- Establishment of trauma registries in selected hospitals as a mechanism for the continuing description of the national history of the various forms of injuries.
- Subsequent consideration of establishment of a national computerized central registry.
- Studies on the feasibility of designating selected injuries to be incorporated with reportable diseases under Public Health Service control.”
40 years later, the American College
of Surgeons has a chapter dedicated to the Trauma Registry in their Resources
for Optimal Care of the Injured Patient 2006 book. Additionally they recognized the trauma
registrar as part of the trauma team, and advocate for trauma registrar
continuing education. The National
Trauma Data Bank (NTDB) was established and is the largest aggregation of
trauma registry data ever assembled. The
goal of the NTDB is to inform the medical community, the public, and the
decision makers about a wide variety of issues that characterize the current
state of care for injured persons. The
2010 annual reports has 682 hospitals reporting, and now contains over 4
million records.