Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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PARK Index for Preventable Major Trauma Death Rate

중증외상환자에서 TRISS를 활용한 예방가능 중증외상사망률 지표: PARK Index

  • Park, Chan Yong (Department of Trauma Surgery, Medical Research Institute, Pusan National University Hospital) ;
  • Yu, Byungchul (Department of Trauma Surgery, Gachon University Medical Center) ;
  • Kim, Ho Hyun (Department of Trauma Surgery, Medical Research Institute, Pusan National University Hospital) ;
  • Hwang, Jung Joo (Department of Trauma Surgery, Medical Research Institute, Pusan National University Hospital) ;
  • Lee, Jungnam (Department of Trauma Surgery, Gachon University Medical Center) ;
  • Cho, Hyun Min (Department of Trauma Surgery, Medical Research Institute, Pusan National University Hospital) ;
  • Park, Han Na (Trauma Center, Pusan National University Hospital)
  • 박찬용 (부산대학교병원 외상외과) ;
  • 유병철 (가천대학교 길병원 외상외과) ;
  • 김호현 (부산대학교병원 외상외과) ;
  • 황정주 (부산대학교병원 외상외과) ;
  • 이정남 (가천대학교 길병원 외상외과) ;
  • 조현민 (부산대학교병원 외상외과) ;
  • 박한나 (부산대학교병원 외상전문센터 지원팀)
  • Received : 2015.06.19
  • Accepted : 2015.10.04
  • Published : 2015.09.30
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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.

Keywords

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