Citation

Maegele M. Eur. J. Trauma Emerg. Surg. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00068-023-02255-3

PMID

36995395

Abstract

Traumatic brain injury (TBI) remains a significant medical and socioeconomic challenge of our times. The age-adjusted incidence across all TBI severities from population-based studies 2015-2020 ranged between 476/100,000 in South Korea to 787/100,000 in the US with temporal trends and variations still confounded by methodological diversity including inconsistent definitions, variations in data capture and interpretation [1]. To further promote and advance the uniform process for the capture and reporting of TBI epidemiology and clinical pathways, a TBI-specific data module, harmonized with other existing multi-/international instruments, was created and technically attached to the German TR-DGU database. In this focus issue of the EJTES, Younsi and colleagues report the different steps of development but also highlight the various challenges that had to be overcome along the winding road of implementation [2]. After several dry runs, the results from the pilot study are presented and put in a broader context.

The work presented by Gunning and colleagues is highly supportive of this endeavour in suggesting variability in injury severity coding to be one of the main drivers for still existing differences in reported mortality after severe TBI across international trauma centers [3]. The authors assessed 150 randomly selected patients from three international local trauma registries--50 patients from each center--and looked for inter- and intra-rater reliability of documented AIS scores. While an almost perfect result was seen for the AIS coders within the same trauma center, the opposite was true when looking at coding between the centers. In consequence, measures to improve inter-rated reliability in coding and for quality control of captured data into registries are mandatory and therefore central to the novel TBI databank within the TR-DGU. ...

Language: en