Dataset Information

Geriatric Trauma - A Rising Tide. Assessing Patient Safety Challenges in a Vulnerable Population Using Norwegian Trauma Registry Data and Focus Group Interviews: Protocol for a Mixed Methods Study.

ABSTRACT: BACKGROUND:Elderly trauma patients constitute a vulnerable group, with a substantial risk of morbidity and mortality even after low-energy falls. As the world's elderly population continues to increase, the number of elderly trauma patients is expected to increase. Limited data are available about the possible patient safety challenges that elderly trauma patients face. The outcomes and characteristics of the Norwegian geriatric trauma population are not described on a national level. OBJECTIVE:The aim of this project is to investigate whether patient safety challenges exist for geriatric trauma patients in Norway. An important objective of the study is to identify risk areas that will facilitate further work to safeguard and promote quality and safety in the Norwegian trauma system. METHODS:This is a population-based mixed methods project divided into 4 parts: 3 quantitative retrospective cohort studies and 1 qualitative interview study. The quantitative studies will compare adult (aged 16-64 years) and elderly (aged ?65 years) trauma patients captured in the Norwegian Trauma Registry (NTR) with a date of injury from January 1, 2015, to December 31, 2018. Descriptive statistics and relevant statistical methods to compare groups will be applied. The qualitative study will comprise focus group interviews with doctors responsible for trauma care, and data will be analyzed using a thematic analysis to identify important themes. RESULTS:The project received funding in January 2019 and was approved by the Oslo University Hospital data protection officer (No. 19/16593). Registry data have been extracted for 33,344 patients, and the analysis of these data has begun. Focus group interviews will be conducted from spring 2020. Results from this project are expected to be ready for publication from fall 2020. CONCLUSIONS:By combining data from the NTR with interviews with doctors responsible for treatment and transfer of elderly trauma patients, we will provide increased knowledge about trauma in Norwegian geriatric patients on a national level that will form the basis for further research aiming at developing interventions that hopefully will make the trauma system better equipped to manage the rising tide of geriatric trauma. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):PRR1-10.2196/15722.

SUBMITTER: Cuevas-Ostrem M

PROVIDER: S-EPMC7226039 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Geriatric Trauma - A Rising Tide. Assessing Patient Safety Challenges in a Vulnerable Population Using Norwegian Trauma Registry Data and Focus Group Interviews: Protocol for a Mixed Methods Study.

Cuevas-Østrem Mathias M Røise Olav O Wisborg Torben T Jeppesen Elisabeth E

JMIR research protocols 20200430 4

<h4>Background</h4>Elderly trauma patients constitute a vulnerable group, with a substantial risk of morbidity and mortality even after low-energy falls. As the world's elderly population continues to increase, the number of elderly trauma patients is expected to increase. Limited data are available about the possible patient safety challenges that elderly trauma patients face. The outcomes and characteristics of the Norwegian geriatric trauma population are not described on a national level.<h4 ...[more]

PMID: 32352386

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Project description:Poaching and illegal trafficking are major threats to biodiversity, especially when endangered felids are concerned. Tigers are iconic animals, and there is huge demand for their body parts both in the national and international illegal markets. India forms the largest tiger conservation unit in the world and poaching is at its peak even though there are stringent laws and strict enforcement. In the present study, we analytically estimated the tiger seizure cases in India from 2001-2021 using newspaper archives as the main source of data. The data was geo-referenced to understand the details of seizure, demand, and locality. We statistically correlated the seizure rate with the density of tigers, tiger reserves, and various other socio-economic factors. Our result shows that skin, claws, bones, and teeth have more demand, with nails and teeth being the most preferred in local markets. The bones, flesh, and other parts were mostly seized in the border states of the north and eastern states. The intensity of seizures is very high in the states of Maharashtra, Karnataka, Tamil Nadu, and Assam. From our analysis, we predict four trade routes for the export of the seized parts: the Nepal-Bhutan border, Assam border, the Brahmaputra, and the Mumbai port. This corresponds to the five tiger conservation blocks in India, and we observed the seizure rate is high near the Western Ghats region, which has not yet been noticed. Apart from the seizure, we are unconcerned with the seizure's origin or the local trading routes. The study demonstrates the importance of identifying the source population using DNA methods and carefully enforcing the rules in area of poaching. We assert that current approaches are incapable of resolving the issue and that a more precise and effective forensic procedure capable of resolving the issue at the minute local level is critical for precisely tracing trade channels.Supplementary informationThe online version contains supplementary material available at 10.1007/s10708-022-10633-4.

Project description:BackgroundThe Norwegian Trauma Registry (NTR) is designed to monitor and improve the quality and outcome of trauma care delivered by Norwegian trauma hospitals. Patient care is evaluated through specific quality indicators, which are constructed of variables reported to the registry by certified registrars. Having high-quality data recorded in the registry is essential for the validity, trust and use of data. This study aims to perform a data quality check of a subset of core data elements in the registry by assessing agreement between data in the NTR and corresponding data in electronic patient records (EPRs).MethodsWe validated 49 of the 118 variables registered in the NTR by comparing those with the corresponding ones in electronic patient records for 180 patients with a trauma diagnosis admitted in 2019 at eight public hospitals. Agreement was quantified by calculating observed agreement, Cohen's Kappa and Gwet's first agreement coefficient (AC1) with 95% confidence intervals (CIs) for 27 nominal variables, quadratic weighted Cohen's Kappa and Gwet's second agreement coefficient (AC2) for five ordinal variables. For nine continuous, one date and seven time variables, we calculated intraclass correlation coefficient (ICC).ResultsAlmost perfect agreement (AC1 /AC2/ ICC > 0.80) was observed for all examined variables. Nominal and ordinal variables showed Gwet's agreement coefficients ranging from 0.85 (95% CI: 0.79-0.91) to 1.00 (95% CI: 1.00-1.00). For continuous and time variables there were detected high values of intraclass correlation coefficients (ICC) between 0.88 (95% CI: 0.83-0.91) and 1.00 (CI 95%: 1.00-1.00). While missing values in both the NTR and EPRs were in general negligeable, we found a substantial amount of missing registrations for a continuous "Base excess" in the NTR. For some of the time variables missing values both in the NTR and EPRs were high.ConclusionAll tested variables in the Norwegian Trauma Registry displayed excellent agreement with the corresponding variables in electronic patient records. Variables in the registry that showed missing data need further examination.

Dataset Information

Geriatric Trauma - A Rising Tide. Assessing Patient Safety Challenges in a Vulnerable Population Using Norwegian Trauma Registry Data and Focus Group Interviews: Protocol for a Mixed Methods Study.

Publications

Geriatric Trauma - A Rising Tide. Assessing Patient Safety Challenges in a Vulnerable Population Using Norwegian Trauma Registry Data and Focus Group Interviews: Protocol for a Mixed Methods Study.

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