Trauma Center-Related Biases in Injury Research

Abstract

Objectives Most studies from trauma centers analyze and present combined data on patients from their surrounding communities and patients referred for specialized services from service areas of other hospitals. Information is needed about the effect of combining data from the two groups on conclusions about injury in the community. Method All injured patients seen in a trauma center emergency department on 30% of days over one year were studied concerning referral status, age, sex, type of activity when injured, injury type and severity, hospitalization, and prior medical history. Results Combining data for both groups suggested an older, more medically impaired population, with more severe injuries, more frequent hospitalization, more serious head and spine injuries, fewer extremity fractures, and fewer household-related and more transportation-related injuries than were actually occurring in the community. Conclusions Data from local and out-of-area referred patients at trauma centers should be analyzed and presented separately in studies from this source if an accurate representation is to be provided of the role of injury in the population at large of the community.