The effect of dead-on-arrival and emergency department death classification on risk-adjusted performance in the American College of Surgeons Trauma Quality Improvement Program.

Background: The American College of Surgeons' Trauma Quality Improvement Program is focused on identifying variations in outcomes across trauma centers for the purposes of performance improvement. In previous analyses, patients who died in the emergency department were excluded. We investigated the effect of inclusion and exclusion of emergency department (ED) deaths (dead on arrival [DOA] and died in ED [DIE]) on analyses of overall risk-adjusted trauma center performance.

Penetrating oesophageal injury: a contemporary analysis of the National Trauma Data Bank.

Background: Oesophageal trauma is uncommon. The aim of this study was to conduct a descriptive analysis of penetrating oesophageal trauma and determine risk factors for oesophageal related complications and mortality in the National Trauma Data Bank (NTDB).

Methods: Patients with penetrating oesophageal trauma from Levels 1 and 2 trauma centres in the NTDB (2007 and 2008) that specified how complication and comorbidity data were recorded were selected.

Duplex ultrasound screening for deep vein thrombosis in asymptomatic trauma patients: a survey of individual trauma surgeon opinions and current trauma center practices.

Background: Many national agencies have suggested that deep vein thrombosis (DVT) rates measure quality of hospital care. However, none provide recommendations for standardized screening. If screening practices vary among clinicians or hospitals, DVT rates could be biased-centers which perform more duplex ultrasounds report more DVTs.

The attributable mortality and length of stay of trauma-related complications: a matched cohort study.

Objective: To determine the attributable mortality (AM) and excess length of stay because of complications or complication groupings in the National Trauma Data Bank.

Summary Background Data: Resources devoted to performance improvement activities should focus on complications that significantly impact mortality and length of stay. To determine which post-traumatic complications impact these outcomes, we conducted a matched cohort study.

Trauma and Injury Severity Score (TRISS) coefficients 2009 revision.

Background: Currently used Trauma and Injury Severity Score (TRISS) coefficients, which measure probability of survival (PS), were derived from the Major Trauma Outcome Study (MTOS) in 1995 and are now unlikely to be optimal. This study aims to estimate new TRISS coefficients using a contemporary database of injured patients presenting to emergency departments in the United States; and to compare these against the MTOS coefficients.

Methods: Data were obtained from the National Trauma Data Bank (NTDB) and the NTDB National Sample Project (NSP).

The Trauma Quality Improvement Program: pilot study and initial demonstration of feasibility.

Objective: The American College of Surgeons Committee on Trauma has created a "Trauma Quality Improvement Program" (TQIP) that uses the existing infrastructure of Committee on Trauma programs. As the first step toward full implementation of TQIP, a pilot study was conducted in 23 American College of Surgeons verified or state designated Level I and II trauma centers. This study details the feasibility and acceptance of TQIP among the participating centers.