Abbreviations AIS Abbreviated Injury Score CT Computerised Tomography DHB District Health Board GCS Glasgow Coma Scale ICD International Classification of Disease ISS Injury Severity Score INR International Normalised Ratio…
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The establishment of the New Zealand Trauma Registry means that for the first time we have the capability to understand the patterns of trauma and the impact this has on individuals, their family/whanau, and the cost to society. The NZ-MTR is an important tool to support a data-driven approach to trauma. This paper explores how the NZ-MTR was established and its potential to bring us in line with formal systems internationally.
To describe the development of the New Zealand Major Trauma Registry (NZ-MTR) and the initial experiences of its use.
The background to the development of the NZ-MTR was reviewed and the processes undertaken to implement a single-instance of a web-based national registry described. A national minimum dataset was defined and utilised. Key structures to support the Registry such as a data governance group were established.
The NZ-MTR was successfully implemented and is the foundation for a new, data-driven model of quality improvement. In its first year of operation over 1,300 patients were entered into the Registry although coverage is not yet universal. Overall incidence is 40.8 major trauma cases/100,000 population. The incidence in the Māori population was 69/100,000 compared with 31/100,000 in the non-Māori population. Case fatality rate was 9%. Three age peaks were observed at 20–24 years, 50–59 years and above 85 years. Road traffic crashes accounted for 50% of all caseload. A significant proportion of major trauma patients (21%) were transferred to one or more hospitals before reaching a definitive care facility.
Despite the challenges working across multiple jurisdictions, initiation of a single-instance web-based registry has been achieved. The NZ-MTR enables New Zealand to have a national view of trauma treatment and outcomes for the first time. It will inform quality improvement and injury prevention initiatives and potentially decrease the burden of injury on all New Zealanders.