Effects of Injury Registry Data on Policymaking, Hospitalizations, and Mortality: Systematic Review.

Abstract

Background: The Brazilian project, launched in 2021, aims to establish a nationwide injury registry that systematically collects detailed information on incidents and individuals across the country, regardless of injury severity. The registry integrates information from prehospital and hospital care, various health systems lacking interoperability, and data from sectors such as firefighters and police. Its primary aim is to enhance health surveillance by providing timely, high-quality information that guides prevention strategies and informs policymaking. In addition, the project seeks to reduce morbidity and mortality associated with injuries.

Objective: This study aimed to investigate the effects of injury registry data on policymaking, hospitalization rates or duration, and mortality.

Methods: The systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a protocol registered in PROSPERO (International Prospective Register of Systematic Reviews, CRD42023481528). A total of 5 databases were searched in November 2023, with an update conducted in March 2024, incorporating reference lists from the studies included. Two reviewers independently screened records, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale, resolving disagreements with a third reviewer. Studies were eligible if they reported results related to the implementation and use of injury or trauma registry data for at least one outcome of interest, while those based on other sources were excluded. Synthesis of findings was presented in tables, and the observed results were reported as number or percentage differences.

Results: Out of 9100 studies retrieved, 3951 were excluded due to duplication, leaving 5149 for selection, with 15 full texts reviewed. Only 5 studies met the inclusion criteria, highlighting a notable scarcity of research on the effects or results of registry data on injury outcomes. It is important to note that the studies included reflect correlations rather than causalities, and there are currently no publications on impact. The findings suggest that injury and trauma registries have the potential to inform policymaking, which can lead to enhanced health outcomes. One study noted a 3-day reduction in intensive care unit stay (from 16 to 13 days; P<.05) and a 4% reduction in expected hospital mortality (from 17.5% to 21.5%) for patients with an Injury Severity Score ≥16, while another showed a 42% annual decrease in traffic injury hospital admissions (from 45 to 16). Significant methodological heterogeneity and the small number of studies limited the feasibility of a meta-analysis.

Conclusions: Establishing an injury registry in Brazil presents a significant opportunity to enhance health outcomes through informed policymaking. While it is crucial to set appropriate expectations regarding its effects on morbidity and mortality, particularly concerning the causality and transportability of the findings to the Brazilian context, its role in facilitating preventive measures and improving surveillance capabilities remains valuable.