National Trauma Data Bank 2008 NTDB Annual Report

NTDB Annual Report 2008 Editors Avery B. Nathens, MD, FACS, Chair Richard J. Fantus, MD, FACS, Chair National Trauma Data Bank Subcommittee Trauma Registry Advisory Ad Hoc Committee American College of Surgeons Committee on Trauma Leadership John J. Fildes, MD, FACS J. Wayne Meredith, MD, FACS Chair, Committee on Trauma Medical Director, Trauma Office Division of Research and Optimal Patient Care National Trauma Data Bank Subcommittee Palmer Q. Bessey, MD, FACS Karen J. Brasel, MD, FACS David E. Clark, MD, FACS Arthur Cooper, MD, FACS Joseph Cuschieri, MD, FACS Richard J. Fantus, MD, FACS Jeffrey S. Hammond, MD, FACS Richard J. Kagan, MD, FACS Geoffrey R. Keyes, MD, FACS Michael D. Mc. Gonigal, MD, FACS Frederick H. Millham, MD, FACS Allen F. Morey, MD, FACS Charles E. Morrow, Jr. , MD, FACS Michael L. Nance, MD, FACS Avery B. Nathens, MD, Ph. D, FACS Manoj R. Shah, MD, FACS Glen H. Tinkoff, MD, FACS N. Clay Mann, Ph. D, MS, Consultant NTDB ® Annual Report 2008 National Trauma Data Bank Staff Melanie Neal, Manager Sandra Goble, Statistician Chrystal Price, Coordinator © American College of Surgeons 2008. All Rights Reserved Worldwide

Acknowledgments The American College of Surgeons Committee on Trauma wishes to thank the Centers for Disease Control and Prevention (CDC) for their support of the NTDB ® Annual Report 2008 © American College of Surgeons 2008. All Rights Reserved Worldwide

Please note: The abbreviation NK/NR used on many tables denotes Not Known, Not Recorded, or Blank. If Not Applicable is not shown as a separate row on the table, then it is also included in the NK/NR category. “Local ISS” denotes ISS scores submitted directly by hospitals regardless of the method of calculation. “ICD 90 Derived” are scores derived by converting ICD 9 codes to AIS using the ICD 90 Mapping program and then calculating ISS with the resulting AIS severity scores. “AIS Derived” are calculated from AIS submitted directly by hospitals. Analyses in this report use the ICD 90 Derived ISS. NTDB ® Annual Report 2008 © American College of Surgeons 2008. All Rights Reserved Worldwide

Figure 1 States and U. S. Territories Submitting to the NTDB Percent of hospitals = Number of hospitals in the state that have submitted to the NTDB divided by the number of hospitals identified by the Trauma Exchange Information Program (TIEP) as trauma centers designated by a state or local authority and/or verified by the American College of Surgeons. 67% or greater 34% to 66% 0% to 33% NTDB ® Annual Report 2008 © American College of Surgeons 2008. All Rights Reserved Worldwide

Figure 2 NTDB ® Annual Report 2008 Facilities by Bed Size © American College

Figure 3 NTDB ® Annual Report 2008 Facilities by Trauma Level © American College

Figure 4 NTDB ® Annual Report 2008 Facilities by Region © American College of

Figure 5 A NTDB ® Annual Report 2008 Incidents by Age © American College

Figure 5 B NTDB ® Annual Report 2008 Case Fatality Rate by Age ©

Figure 6 A NTDB ® Annual Report 2008 Incidents by Age and Gender ©

Figure 6 B NTDB ® Annual Report 2008 Case Fatality Rate by Age and

Figure 7 NTDB ® Annual Report 2008 Alcohol Use © American College of Surgeons

Figure 8 NTDB ® Annual Report 2008 Drug Use © American College of Surgeons

Figure 9 NTDB ® Annual Report 2008 Primary Payment Source © American College of

Figure 10 A NTDB ® Annual Report 2008 Incidents by Mechanism of Injury ©

Figure 11 B NTDB ® Annual Report 2008 Case Fatality Rate by Mechanism of

Figure 11 NTDB ® Annual Report 2008 Mechanism of Injury by Age © American

Figure 12 NTDB ® Annual Report 2008 Case Fatality Rate by Mechanism of Injury

Figure 13 A NTDB ® Annual Report 2008 Incidents by Mechanism of Injury and

Figure 13 B NTDB ® Annual Report 2008 Case Fatality Rate by Mechanism of

Figure 14 NTDB ® Annual Report 2008 Incidents by Comparative Injury Severity Scores ©

Figure 15 NTDB ® Annual Report 2008 Case Fatality Rate by Injury Severity Score

Figure 16 NTDB ® Annual Report 2008 Incidents by Injury Severity Score and Age

Figure 17 Case Fatality Rate by Injury Severity Score and Age NTDB ® Annual

Figure 18 A NTDB ® Annual Report 2008 Incidents by Work-Related Injuries © American

Figure 18 B NTDB ® Annual Report 2008 Case Fatality Rate by Work-Related Injuries

Figure 19 NTDB ® Annual Report 2008 Case Fatality Rate by Intent © American

Figure 20 NTDB ® Annual Report 2008 Case Fatality Rate by Location E-code ©

Figure 21 Incidents by AIS Body Region Note: An incident may involve multiple organ systems and a patient will then be counted in each of the organ systems in which there is an injury. NTDB ® Annual Report 2008 © American College of Surgeons 2008. All Rights Reserved Worldwide

Figure 22 Incidents with AIS ≥ 3 by AIS Body Region Note: An incident may involve multiple body regions, and, if so, the patient will be counted in each of the categories in which there is an injury. NTDB ® Annual Report 2008 © American College of Surgeons 2008. All Rights Reserved Worldwide

Figure 23 Case Fatality Rate by AIS Body Region Note: an incident may involve multiple body regions, and, if so, the patient will be counted in each of the categories in which there is an injury. NTDB ® Annual Report 2008 © American College of Surgeons 2008. All Rights Reserved Worldwide

Figure 24 NTDB ® Annual Report 2008 Incidents by Protective Devices © American College

Figure 25 NTDB ® Annual Report 2008 Median Total EMS Length (Mins) by Mechanism

Figure 26 Median Total EMS Length (Mins) by Injury Severity Score NTDB ® Annual

Figure 27 NTDB ® Annual Report 2008 Median Length of Stay (Days) by Mechanism

Figure 28 NTDB ® Annual Report 2008 Median Length of Stay (Days) by Injury

Figure 29 NTDB ® Annual Report 2008 Median Ventilator Days by Mechanism of Injury

Figure 30 NTDB ® Annual Report 2008 Median Ventilator Days by Injury Severity Score

Figure 31 NTDB ® Annual Report 2008 Median ICU Days by Mechanism of Injury

Figure 32 NTDB ® Annual Report 2008 Median ICU Days by Injury Severity Score

Figure 33 NTDB ® Annual Report 2008 Incidents by ED Discharge Disposition © American

Figure 34 NTDB ® Annual Report 2008 Reasons for Death in Emergency Department ©

Figure 35 NTDB ® Annual Report 2008 Incidents by Hospital Discharge Disposition © American

Figure 36 NTDB ® Annual Report 2008 Incidents by Hospital Complications © American College

Figure 37 NTDB ® Annual Report 2008 Incidents by Region © American College of

Figure 38 NTDB ® Annual Report 2008 Case Fatality Rate by Region © American

Figure 39 NTDB ® Annual Report 2008 Mechanism of Injury by Region © American

Figure 40 NTDB ® Annual Report 2008 Injury Severity Score by Region © American

Resources • www. ntdb. org for more information about NTDB • www. ntdbdatacenter. com to transmit data to NTDB • www. ntdsdictionary. org for information on the new data standard NTDB ® Annual Report 2008 © American College of Surgeons 2008. All Rights Reserved Worldwide