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Are the ACSCOT filters associated with outcome? Examining morbidity and mortality in a European setting
- Source :
- Injury. 39(9)
- Publication Year :
- 2007
-
Abstract
- Summary Introduction Quality indicators are widely needed for external assessment and comparison of trauma care. It is common to extend the use of the American College of Surgeons Committee on Trauma (ACSCOT) audit filters to this scope. This mandates that their actual link with outcome be demonstrated. Several studies attempted to do so, but with inconsistent risk-adjustment, conflicting results and never using long-term disability as outcome measure, despite its recognised importance. We tried to overcome these limitations. Methods Risk-adjusted analysis of the association of filters 1, 3, 10 and 13 with 30-day mortality and 6-month disability measured with the EQ5D scale. Multivariate logistic and linear regression models were used respectively. The data came from a National Italian Trauma Registry comprising 838 patients with major trauma. Results Three (1, 3 and 10) of the filters analysed did not show any significant association with either outcome. Filter 13 was associated with decreased mortality and lower (worse) disability scores. Conclusions Methodological difficulties, incomplete, obsolete or non-generalisable definitions of some filters can explain the generally poor correlation with outcomes. The conflicting association of filter 13 with the two types of outcomes raises some interesting questions about the targeted outcomes in trauma research. It is recommended that further studies develop better quality indicators and test their link with both survival and functional outcome in the same setting where they are applied for assessment and comparison of trauma care.
- Subjects :
- Registrie
Adult
Male
Trauma centres
medicine.medical_specialty
Pediatrics
Multivariate statistics
Quality indicators (health care)
media_common.quotation_subject
Audit
Outcome (game theory)
Trauma Centers
Epidemiology
medicine
Outcome assessment (health care)
Humans
Quality (business)
Registries
Hospital Mortality
Intensive care medicine
Wounds and injuries
Societies, Medical
General Environmental Science
media_common
Quality Indicators, Health Care
business.industry
Major trauma
Middle Aged
Trauma centre
medicine.disease
Test (assessment)
Logistic Models
Outcome and Process Assessment, Health Care
Italy
Scale (social sciences)
Multivariate Analysis
General Earth and Planetary Sciences
Wounds and Injuries
Female
business
Subjects
Details
- ISSN :
- 18790267
- Volume :
- 39
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Injury
- Accession number :
- edsair.doi.dedup.....aa9f65a4c491684fff7d6a36490e24be