2. Some Trauma Related Discussions Happened since
the Last TSAC Meeting
■ The 2020 Trauma data is ready (Kudos to IICRC!).
■ Timely Trauma data – IICRC will report late submissions to State
(Brett Cross) and Regional PIPS leaders.
■ Regional PIPS plan
– Educate members about regional audit filters (IICRC via zoom).
– Make sure that confidentiality/HIPAA agreement forms are
signed.
– Customized data query per Regional PIPS' request (Data request
form required).
– Push out regional NEMSIS report to Regional PIPS members.
■ New audit filters will be observed internally without being on the
trauma dashboard to see if they are worth keeping. Details will be
discussed at the State PIPS meeting.
■ Cause Code training for trauma registrars, especially FALL vs. specific
activities in which falls happened (e.g., SPORT, MC, OV, etc.).
3. The 2020 Trauma Data with 5-year Trend
■ The 2020 Trauma data is available now.
■ Year 2020 was the strangest year with the pandemic.
■ Some highlights in the past 5 years (2016 - 2020).
■ Year 2016 was the year of transition from ICD-9 to ICD-10 (so
the data is different from the rest of the years).
■ The year (injury year) was defined as the year the patient is
arrived at the hospital.
■ Age groups were defined as Pediatric (age 0-14), Adult (age
15-64), and Geriatric (age 65+).
■ Utah population estimates for 2020 was obtained from the
Office of Public Health Assessment (not on the Census
website yet).
19. ROC curve comparisons for ISS, TRISS, pDeath (TMPM
probability of death) prediction of death : 2016-2020
Blunt
N=57,267
Dead = 1,298
Penet.
N=2,849
Dead = 199
20. ROC curve comparisons for Peds. Trauma: 2016-2020
Blunt
N= 6,150
Dead = 61
Penet.
N=183
Dead = 10
21. ROC curve comparisons for Adult Trauma: 2016-2020
Blunt
N= 27,192
Dead = 491
Penet.
N=2,524
Dead = 176
22. ROC curve comparisons for Geri. Trauma: 2016-2020
Penet.
N=142
Dead = 13
Blunt
N=23,923
Dead = 746
23. ROC curve comparisons for ISS, TRISS, pDeath
(TMPM probability of death): 2016-2020 Cont.
■ TRISS (from ED) seems to be a better predictor of death than ISS and
pDeath in our 5-year Trauma data for Blunt and Penetrating injuries.
■ More accurate for pediatric and adult patients, less so for geriatric
patients.
■ Caveats – TRISS values are missing 16%-18% (2016-2020 data including
all age groups)
■ Need to decrease missing TRISS values
■ Ask registrars availability of TRISS values (RTS – GCS, SBP, RR) in ED
records (especially if patients were transported out)
Injury Type Count
ED TRISS missing % ED TRISS missing ISS missing % ISS missing pDeath missing % pDeathmissing
Blunt 68,279 11,012 16.1% 30 0.04% 495 0.7%
Penetrating 3,453 604 17.5% 0 0% 42 1.2%
Per capita injury number went down for the geriatric population
Among the injured pediatric patients, their mortality rate was the lowest in 2020. Per capita mortality was the lowest for the geriatric patients in 2020.
Per-capita Work-related trauma cases were unchanged.
Per capita suspected abuse reported numbers declined. Just about 1/3 of previous years. (had the data since 2018)
ROC curve – receiver operating characteristic curve (illustrates the diagnostic ability of a binary classifier system).
