Trauma registries compared: A systemic review of the barriers, enablers, and the path to standardisation

Abstract

National trauma registries were introduced 20 years ago to improve care of the multiply injured patients through benchmarking and accreditation of dedicated trauma centres. However, variability in registry design, lack of long-term functional outcome data has limited its use. A standardised dataset has been agreed upon, but not implemented which has made it difficult to obtain meaningful results, particularly in frail elderly populations.

This narrative synthesis aims to identify enablers of standardised data collection and reporting, that improves care within all levels of hospitalised trauma patients. Eligible studies were identified through systematic searches of Medline, EMBASE, and PsycINFO databases using a comprehensive algorithm designed to maximise sensitivity. Registry websites, annual reports, and data dictionaries were also reviewed. Two researchers independently screened studies extracted data on barriers and enablers, and assessed study quality using the Methodological Index for Non-Randomised Studies (MINORS). A thematic analysis was conducted to synthesise findings.

Barriers to effective registry included inconsistent funding, limited infrastructure and exclusion of high-risk groups, such as elderly. Enablers included government mandates, standardised methods and broad inclusion criteria. While many registries demonstrated improved mortality tracking and injury prevention strategies, very few captured long-term disability outcomes or needs of elderly patients.

Trauma care requires standardised registries with comparable datasets to enable benchmarking and improve outcomes focussed on recovery from the long-term impacts of trauma, particularly among frail elderly populations. Collaboration between trauma registries of all levels is essential to develop robust systems that drive meaningful changes in practice worldwide.