Content area
Full text
Introduction
More than five million people die annually from injuries. Traumatic injuries are the leading cause of death for individuals aged 15–29 years and rank among the top three causes of death and disability for those aged 5–44 years globally [1, 2]. In the WHO European Region, approximately 530 000 people, including nearly 42 000 children and adolescents, died from violence and unintentional injury in 2015 [3]. In Norway, 2045 people died from accidents and suicide in 2022 [4]. Injuries impose significant costs on both individuals and society [1].
While primary prevention is the most cost-effective method for reducing injury-related death and disability, health systems must provide optimal care for injured patients (secondary prevention) [5, 6]. Inclusive trauma systems incorporate high-level trauma centres for the most severely injured and acute care hospitals for less severe cases, involving prehospital services, rehabilitation, community and social care, public health, and commissioners [2]. Historically, regional or state-wide trauma systems centred on major trauma centre have been associated with reduced mortality among severely injured patients [2, 7, 8, 9, 10, 11, 12–13]. However, recent studies suggest that as systems mature, outcome differences between levels of care diminish [7, 14]. Nonetheless, the benefits of higher-level trauma centres may remain more pronounced in cases of severe injury [15, 16], highlighting the importance of continuous evaluation. Improvements in trauma care require detailed knowledge of trauma epidemiology, patient demographics, interventions, clinical outcomes, and the patient journey throughout the treatment chain [17]. Differences in infrastructure, socio-political contexts, geography, healthcare systems, climates, transportation distances, the maturity of pre- and in-hospital trauma systems and the urban-rural mix contribute to variations in trauma systems across countries [18, 19–20]. Given these differences, national and international comparisons and benchmarking of trauma care are crucial for identifying key factors associated with good outcomes [21]. To effectively monitor trauma system quality, populations-based regional and national trauma registries are essential, tracking major trauma care processes and outcomes across the entire trauma system [22]. These registries facilitate hospital and system quality improvement and can be used for benchmarking outcomes through prediction models and assessing process and resource efficiency [23, 24, 25–26]. Additionally, trauma registries support hypothesis generation, study protocol planning, and injury surveillance [27].
Trauma registries should also assess post-hospital treatment phases, including rehabilitation,...