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J Trauma Inj > Volume 28(3); 2015 > Article
Journal of Trauma and Injury 2015;28(3):115-122.
DOI: https://doi.org/10.20408/jti.2015.28.3.115    Published online September 30, 2015.
PARK Index for Preventable Major Trauma Death Rate
Chan Yong Park, Byungchul Yu, Ho Hyun Kim, Jung Joo Hwang, Jungnam Lee, Hyun Min Cho, Han Na Park
1Department of Trauma Surgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea. wkafyddl@hanmail.net
2Department of Trauma Surgery, Gachon University Medical Center, Incheon, Korea.
3Coordinator, Trauma Center, Pusan National University Hospital, Busan, Korea.
중증외상환자에서 TRISS를 활용한 예방가능 중증외상사망률 지표: PARK Index
박찬용, 유병철1, 김호현, 황정주, 이정남1, 조현민, 박한나2
부산대학교병원 외상외과,
1가천대학교 길병원 외상외과,
2부산대학교병원 외상전문센터 지원팀
Received: 19 June 2015   • Revised: 19 June 2015   • Accepted: 4 October 2015
Abstract
PURPOSE
To calculate Preventable Trauma Death Rate (PTDR), Trauma and Injury Severity Score (TRISS) is the most utilized evaluation index of the trauma centers in South Korea. However, this method may have greater variation due to the small number of the denominator in each trauma center. Therefore, we would like to develop new indicators that can be used easily on quality improvement activities by increasing the denominator.
METHODS
The medical records of 1005 major trauma (ISS >15) patients who visited 2 regional trauma center (A center and B center) in 2014 were analyzed retrospectively. PTDR and PARK Index (Preventable Major Trauma Death Rate, PMTDR) were calculated in 731 patients with inclusion criteria. We invented PARK Index to minimize the variation of preventability of trauma death. In PTDR the denominator is all number of deaths, and in PARK Index the denominator is number of all patients who have survival probability (Ps) larger than 0.25. Numerator is the number of deaths from patients who have Ps larger than 0.25.
RESULTS
The size of denominator was 40 in A center, 49 in B center, and overall 89 in PTDR. The size of denominator was significantly increased, and 287 (7.2-fold) in A center, 422 (8.6-fold) in B center, and overall 709 (8.0-fold) in PARK Index. PARK Index was 12.9% in A center, 8.3% in B center, and overall 10.2%.
CONCLUSION
PARK Index is calculated as a rate of mortality from all major trauma patients who have Ps larger than 0.25. PARK Index obtain an effect that denominator is increased 8.0-fold than PTDR. Therefore PARK Index is able to compensate for greater disadvantage of PTDR. PARK Index is expected to be helpful in implementing evaluation of mortality outcome and to be a new index that can be applied to a trauma center quality improvement activity.
Key Words: Trauma; Death; Index; Variation; Quality improvement


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