The Swedish Trauma Registry (SweTrau)

Trauma is the most common cause of death during the first four decades of life in most developed countries. There are also three disabled for every death. Thus, trauma causes great suffering, considerable disability and consequently great costs.

In 2008, The Swedish Trauma Society, a sub-association of The Swedish Surgical Society, initiated the development of a Swedish Trauma Registry (SweTrau). The official startup for SweTrau was in June 2011, and the dataset developed for the registry is very much in line with the European consensus protocol, ”The Utstein Template”.

Aims

The aims of the registry are

  • to monitor trauma patients’ care to identify strengths and weaknesses concerning patient categories, catchment areas and individual hospitals
  • to focus on hospital care of serious trauma
  • to include a prehospital component and to have a posthospital perspective, including rehabilitation and final outcomes
  • to be nationwide
  • to report on measures of outcome and indicators of quality, which are important dimensions of patient safety
  • to form the basis for clinical research and in-depth studies.

Measurement and target values

Survival correlated to degree of injury (case-mix) is the primary measure in the registry for process and outcome. This is reported per hospital. The internationally established measure of disability GOS (Glasgow Outcome Scale) is also included.

At present 48 (out of 49) hospitals in Sweden receiving serious trauma are connected to SweTrau. The registry mainly focuses on injuries that demand surgery and/or intensive care, although every hospital decides what degree of injury that motivates registration. In international comparisons the most serious injuries with ISS (Injury Severity Score)/NISS (New Injury Severity Score) >15 will be studied.

Participating hospitals are responsible for entering, processing and presenting their own data. They must also ensure that local users are authorized to handle journal data. Extraction of own local data can be done for research, improvement work and follow-up, where the participating hospital is responsible for ensuring that this is done in accordance with the laws and regulations that exist at the hospital/principal.

SweTrau is designed to enable scientific processing with epidemiological technology. Research projects can be initiated by the steering group, members or other interested parties. All research projects, both local and regional as well as nationwide, must be reported to the steering group’s research manager/steering group and all approved research projects concerning data from several hospitals must be registered and posted on the website. SweTrau’s steering group decides whether projects should be granted extraction of register data in cases where the extraction applies to several hospitals. Permission from the ethics review board must also be available for withdrawal from the register. When using register data from SweTrau, SweTrau must always be stated as the source. When using own data for student work, scientific publications, projects or improvement work, the testing takes place locally according to the own hospital’s guidelines, but even if the testing takes place locally, the work must still be reported to SweTrau’s research manager in order to get an overall picture of what SweTrau is used for.

Feedback and development

Analysis/feedback must be done electronically, where participating hospitals have direct access to their own data and the collective data from all hospitals. Annual user meetings will improve feedback and development of the registry. Through detailed knowledge of the scope and results of trauma care it will be possible to identify types of injuries and hospitals where there is potential för improvement. Every year an annual report is compiled that describes the development in SweTrau in more general terms.

Inclusion criteria

  • all patients who have experienced a traumatic event and where a trauma alarm has been sounded at the hospital
  • inpatients with NISS >15, even if they did not trigger a trauma alarm
  • patients who are transferred to the hospital within seven days after the traumatic event and have NISS> 15.

Exclusion criteria

  • patients where the only traumatic injury is a chronic subdural hematoma
  • patients where a trauma alarm is triggered without an underlying traumatic event.

In order for a secondary transported patient (transport of a patient who has already come under care and is medically stabilized, usually between hospitals) to be included in SweTrau the injury must not be older than seven days when the patient arrives at the secondary hospital. For the patient who comes directly from the scene of the injury to the hospital no more than 24 hours must have elapsed from the time of the injury to the hospital arrival for registration to take place.

Publicerad: 8 januari 2021
Senast uppdaterad: 10 augusti 2021