Citation

Tsur AM, Nadler R, Lipsky AM, Levi D, Bader T, Benov A, Glassberg E, Chen J. J. Trauma Acute Care Surg. 2020; ePub(ePub): ePub.

Affiliation

Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel.

Copyright

(Copyright © 2020, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000002776

PMID

32355102

Abstract

BACKGROUND: Trauma is the leading cause of death among casualties between 1-44 years. A large proportion of trauma deaths occurs even before arriving at a medical facility. The paucity of prehospital data is a major reason for the lagging development of prehospital trauma care research. This study aims to describe the Israel Defense Forces Prehopistal Trauma Registry, the steps taken to improve data collection and quality, the resulting trends, and the registry's contribution to policymaking.

METHODS: This study explores the quantity and quality of point-of-injury and prehospital data in the registry between the years 1997-2018. We assessed the number of recorded casualties per year, casualties characteristics, documentation variables in the registry, with a specific focus on documentation of vital signs throughout the years.

RESULTS: Overall, 17,905 casualties were recorded. Most casualties were young males (88.6%) - military personnel (52.7%), Syrian refugees (16.2%), Israeli civilians (11.5%), and Palestinians (9.0%). The median number of anuual records from 2006 onwards was significantly higher compared to before 2006 (1000 IQR 792-1470 vs. 142 IQR 129-156). Between 2010 and 2018, documentation rate increased in all vital signs investigated including: heart rate (56.3% vs. 1.0%), level of consciousness (55.1% vs. 0.3%), respiratory rate (51.8% vs. 0.3%), blood oxygen saturation (50.0% vs. 1.0%), Glasgow Coma Scale (48.2% vs 0.4%), systolic blood pressure (45.7% vs. 0.8%), and pain (19.1% vs. 0.5%).

CONCLUSION: Point-of-injury and prehospital documentation are rare yet essential for ongoing improvement of combat casualty care. The IDF-TR is one of the largest and oldest prehospital computerized military trauma registries in the world. This study shows a major improvement in the quantity and then in the quality of prehospital documentation throughout the years that affected guidelines and policy. Further work will focus on improving data completeness and accuracy. LEVEL OF EVIDENCE: Level III, retrospective study.

Language: en