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Der Datensatz des TraumaRegister DGU®, seine Entwicklung über 25 Jahre und Fortschritte in der Schwerverletzenversorgung

The TraumaRegister DGU® dataset, its development over 25 years and advances in the care of severely injured patients

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Zusammenfassung

Hintergrund

Seit der Veröffentlichung 1993 haben sich Datensatz und Dokumentationsbogen des TraumaRegister DGU® (TR-DGU) stetig weiterentwickelt. Anlässlich des 25-jährigen Jubiläums wurde diese Entwicklung untersucht und im Spiegel des medizinischen Fortschritts in der Schwerverletztenversorgung reflektiert.

Material und Methoden

Fünf Referenzdokumentationsbogen für die Jahre 1993, 1996, 2002, 2009 und 2016 wurden in die Untersuchung eingeschlossen. Alle darin abgefragten Informationseinheiten (Items) wurden in der Studiendatenbank erfasst, thematisch kategorisiert und zur weiteren Analyse ausgezählt.

Ergebnis

Die 4‑seitige Gliederung des Bogens ist seit 1993 praktisch unverändert und umfasst im Mittel 212 Items. Insgesamt wurden 491 Items identifiziert, von denen sich 64 durchgehend im Datensatz wiederfanden. Bezogen auf den mittleren Umfang der Bogen entspricht das ca. 30 %. Der Datensatz ist tatsächlich viel konsistenter, als diese Zahl vermuten lässt, weil viele Änderungen auf ein geschickteres Bogendesign zurückgeführt werden können. Die meisten Items entfallen auf die Kategorien „Befund/Diagnose“ (143 Items, 29,1 %), Gerinnung (104, 21,2 %) und „operatives Vorgehen“ (40, 8,1 %). Viele Items dienen als Rohdaten zur Berechnung von Risikoprognose-Scores z. B. Trauma and Injury Severity Score (TRISS), Revised Injury Severity Classification II (RISCII) oder Trauma Associated Severe Hemorrhage (TASH). Derzeit können aus dem Datensatz 9 Scores berechnet werden.

Schlussfolgerung

Die Mitglieder des Arbeitskreises TraumaRegister sind alle aktiv in der Schwerverletztenversorgung tätig. Seit 25 Jahren gelingt es ihnen, aktuelle medizinische Entwicklungen und etablierte wichtige Parameter bei relativ konstantem Dokumentationsaufwand im Datensatz des TR-DGU zu vereinigen. Praxis statt Theorie ist die treibende Kraft hinter dieser Entwicklung, die der Qualitätssicherung und Erforschung der Schwerverletztenversorgung dient.

Abstract

Background

Since the publication in 1993, the dataset and documentation form of the TraumaRegister DGU® (TR-DGU) have continuously evolved. On the occasion of the 25th anniversary the authors have analyzed this evolution in order to reflect it in the light of medical progress in the treatment of the severely injured.

Material and methods

Enrolled in the study were 5 reference data entry sheets from the years 1993, 1996, 2002, 2009 and 2016. Every piece of information (item) queried therein was entered into the study database, was categorized by topic and counted for further analysis.

Results

The arrangement of the 4‑page data entry form has remained practically unchanged since 1993 and includes an average of 212 items. A total of 491 items were identified of which 64 were present throughout every dataset. Based on the average extent of the form this equals a proportion of approximately 30%. The dataset actually shows much more consistency than this number suggests because many changes can be traced back to a smarter design of the data entry form. Most items fell into the categories “results/diagnosis” (143 items/29.1%), “coagulation” (104/21.2%) and “surgical approach” (40/8.1%). Many items serve as raw data for the calculation of prognostic risk scores, such as the trauma and injury severity score (TRISS), the revised injury severity classification II (RISC II) and the trauma associated severe hemorrhage (TASH) score. Currently, nine scores can be calculated from the dataset.

Conclusion

The members of the working group TraumaRegister all actively participate in the treatment of severely injured patients. For 25 years this group has managed to unify the latest medical developments and well-established parameters within the TR-DGU dataset at a relatively constant degree of effort for documentation. Practice in place of theory is the driving force behind this development that serves quality assurance and research in the treatment of severely injured patients.

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Authors and Affiliations

  1. Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der Universität München, LMU München, Schillerstr. 51, 80336, München, Deutschland

    H. Trentzsch

  2. Klinik für Unfallchirurgie, Orthopädie & Sporttraumatologie, Klinikum der Privaten Universität Witten/Herdecke , Köln-Merheim, Deutschland

    M. Maegele & T. Paffrath

  3. Institut für Forschung in der operativen Medizin (IFOM), Universität Witten/Herdecke, Köln, Deutschland

    M. Maegele & R. Lefering

  4. AUC Akademie der Unfallchirurgie GmbH, München, Deutschland

    U. Nienaber

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  1. H. Trentzsch
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  2. M. Maegele
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  3. U. Nienaber
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  4. T. Paffrath
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  5. R. Lefering
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Correspondence to H. Trentzsch.

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Interessenkonflikt

H. Trentzsch, M. Maegele, U. Nienaber, T. Paffrath und R. Lefering geben an, dass kein Interessenkonflikt besteht.

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Trentzsch, H., Maegele, M., Nienaber, U. et al. Der Datensatz des TraumaRegister DGU®, seine Entwicklung über 25 Jahre und Fortschritte in der Schwerverletzenversorgung. Unfallchirurg 121, 794–801 (2018). https://doi.org/10.1007/s00113-018-0555-y

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