Accuracy of Institutional Orthopaedic Trauma Databases: A Retrospective Chart Review

Abstract Introduction: Academic trauma institutions rely on fracture databases as research and quality control tools. Frequently, these databases are populated by trainees, but the completeness and accuracy of such databases has not yet been evaluated. The purpose of this study is to determine the capture rate of a resident-populated database in collecting extremity fractures and to determine the accuracy of assigned Orthopaedic Trauma Association (OTA) classifications.Materials and Methods: A retrospective study was performed at a level one trauma center of all adult patients who underwent treatment for extremity fractures after an emergency department or inpatient consultation. A 20% random sample was taken from these entries and compared to a resident-populated fracture database designed to capture the same patients. For all matching records containing a resident-assigned OTA classification, relevant imaging was blindly reviewed by a trauma fellowship-trained orthopaedic attending surgeon for fracture pattern classification. Resident OTA classifications were compared to this gold standard to determine overall accuracy rate.Results: 318 (80%) out of 400 entries were captured by the resident-populated database. 231 of these 318 entries contained an OTA classification. 153 (66%) of these 231 entries demonstrated concordance between resident and attending assigned OTA classifications. On subgroup analysis, 133 (70%) of the 190 lower extremity classifications were accurately identified as compared to just 20 (49%) of the 41 upper extremity classifications (p = 0.009). 79 (65%) of the 121 end segment fractures showed agreement versus 42 (67%) of the 63 diaphyseal injury patterns (p = 0.85). Accuracy of classification did not significantly vary by resident year of training (p = 0.142). Conclusion: Trainee generated databases at academic institutions may be subject to incomplete data entry and inaccurate fracture classifications. Quality control measures should be instituted to ensure accuracy in such databases if efforts are invested with the expectation of useful information.

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Accuracy of institutional orthopedic trauma databases: a retrospective chart review

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02478-3 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Aman Chopra ◽

Abigail C. Cortez ◽

Ashraf El Naga ◽

Anthony Ding ◽

Saam Morshed

Keyword(s):

Quality Control ◽

Chart Review ◽

Capture Rate ◽

Data Entry ◽

Retrospective Chart Review ◽

Fracture Pattern ◽

Control Measures ◽

Injury Patterns ◽

Level 1 ◽

Level 1 Trauma Center

Abstract Introduction Academic trauma institutions rely on fracture databases as research and quality control tools. Frequently, these databases are populated by trainees, but the completeness and accuracy of such databases has not yet been evaluated. The purpose of this study is to determine the capture rate of a resident-populated database in collecting extremity fractures and to determine the accuracy of assigned Orthopaedic Trauma Association (OTA) classifications. Materials and methods A retrospective study was performed at a level 1 trauma center of all adult patients who underwent treatment for extremity fractures after an emergency department or inpatient consultation. A 20% random sample was taken from these entries and compared to a resident-populated fracture database designed to capture the same patients. For all matching records containing a resident-assigned OTA classification, relevant imaging was blindly reviewed by a trauma fellowship-trained orthopedic attending surgeon for fracture pattern classification. Resident OTA classifications were compared to this gold standard to determine overall accuracy rate. Results Three hundred eighteen (80%) out of 400 entries were captured by the resident-populated database. Two hundred thirty-one of these 318 entries contained an OTA classification. One hundred fifty-three (66%) of these 231 entries demonstrated concordance between resident and attending assigned OTA classifications. On subgroup analysis, 133 (70%) of the 190 lower extremity classifications were accurately identified as compared to just 20 (49%) of the 41 upper extremity classifications (p = 0.009). Seventy-nine (65%) of the 121 end segment fractures showed agreement versus 42 (67%) of the 63 diaphyseal injury patterns (p = 0.85). Accuracy of classification did not significantly vary by resident year of training (p = 0.142). Conclusion Trainee generated databases at academic institutions may be subject to incomplete data entry and inaccurate fracture classifications. Quality control measures should be instituted to ensure accuracy in such databases if efforts are invested with the expectation of useful information.

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Completely Resistant Acinetobacter baumannii Strains

Infection Control and Hospital Epidemiology ◽

10.1086/502091 ◽

2002 ◽

Vol 23 (8) ◽

pp. 477-479 ◽

Cited By ~ 44

Author(s):

Siham Mahgoub ◽

Jimi Ahmed ◽

Aaron E. Glatt

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Infection Control ◽

Acinetobacter Baumannii ◽

Broad Spectrum ◽

Chart Review ◽

Retrospective Chart Review ◽

Control Measures ◽

Teaching Hospitals ◽

Infection Control Measures

Abstract Nosocomially acquired completely resistant Acinetobacter baumannii strains are a major clinical concern. We identified completely resistant A. baumannii in 6 (4.9%) of 122 A. baumannii isolates in a retrospective chart review at two teaching hospitals. All of these patients had received broad-spectrum antibiotics and had severe underlying comorbid illnesses, long hospitalizations, or recent surgical procedures; 3 had been in the intensive care unit. Five (83%) of the 6 patients were older than 70 years. Only one death occurred. Strict infection control measures may limit further spread.

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Outcomes of second targeted therapy in metastatic renal carcinoma: A retrospective chart review in the EU.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.558 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 558-558

Author(s):

Daniel Yick Chin Heng ◽

Jinhee Park ◽

James E. Signorovitch ◽

Hongbo Yang ◽

Jinlin Song ◽

...

Keyword(s):

Targeted Therapy ◽

Chart Review ◽

Data Entry ◽

Retrospective Chart Review ◽

Patient Characteristics ◽

Eligibility Criteria ◽

Kaplan Meier ◽

The Uk ◽

Sites Of Metastases ◽

The Eu

558 Background: This study describes the real-world outcomes of metastatic renal cell carcinoma (mRCC) patients treated with everolimus (EVE), sorafenib (SOR), and axitinib (AXI) as 2nd targeted therapy in the UK, Germany, and France. Methods: A retrospective chart review was conducted among oncologists and urologists in the UK, Germany and France. Charts were reviewed for adult mRCC patients satisfying the following eligibility criteria: 1) experienced disease progression on 1st targeted therapy with sunitinib or pazopanib; 2) initiated 2nd targeted therapy with EVE, AXI, or SOR between 10/2012 and 6/2013. Kaplan-Meier analysis was used to estimate overall survival (OS) after initiation of 2nd targeted therapy among all patients and stratified by type of 2nd targeted therapy. Results: A total of 281 charts were reviewed, with 99, 91, and 91 mRCC patients receiving EVE, AXI, and SOR as 2nd targeted therapy, respectively. Mean age was 60.6 years old at initial mRCC diagnosis and 65.5% were male. The majority of patients used sunitinib (79.4%), with the rest using pazopanib (20.6%) as 1st targeted therapy. Median duration of 1st targeted therapy was 9.7 months. At the initiation of 2nd targeted therapy, 91.8% of patients had an ECOG score ≤ 2. The most common sites of metastases were lung (71.2%), bone (53.0%), and lymph nodes (47.0%). Median OS from the initiation of 2nd targeted therapy among all patients was 21.8 months (95% CI: 16.5-26.2). The median OS was 23.0, 23.5, and 18.7 for EVE, AXI, and SOR respectively. The majority of patients (87.5%) initiated 2nd targeted therapy on the recommended dose. Patients receiving AXI had a higher rate of dose increase (13.2%), compared to EVE (1.0%) and SOR (0.0%), while patients on EVE had a higher rate of dose decrease (12.1%), compared to AXI (5.5%) and SOR (8.8%). Conclusions: In this retrospective chart review study of several EU countries, the observed median OS was numerically comparable for EVE and AXI, but rates of dose adjustment differed by treatments. Retrospective chart reviews may be subject to selection bias and errors in data entry, and further analysis is underway to address confounding effects of unobserved patient characteristics.

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All-terrain vehicle major injury patterns in children: a five-year review in Southwestern Ontario

CJEM ◽

10.1017/s1481803500013841 ◽

2006 ◽

Vol 8 (04) ◽

pp. 277-280 ◽

Cited By ~ 11

Author(s):

Khalid Alawi ◽

Tim Lynch ◽

Rod Lim

Keyword(s):

Chart Review ◽

Injury Severity ◽

Average Length ◽

Head Injuries ◽

Length Of Hospital Stay ◽

Retrospective Chart Review ◽

Injury Patterns ◽

Patient Demographics ◽

Major Injury ◽

London Health

ABSTRACTObjective:The aim of the study was to characterize the nature of the injuries sustained by children involved in all-terrain vehicle (ATV) crashes in Southwestern Ontario over a 5-year period.Methods:A retrospective chart review was conducted of children who sustained ATV-related trauma and who presented to the emergency department at the Children's Hospital of Western Ontario between Sept. 1, 1998, and Aug. 31, 2003, with an Injury Severity Score (ISS) ≥ 12. Patients were identified by the London Health Sciences Centre Trauma Program Registry. Patient charts were then retrieved and reviewed to record patient demographics, injuries, interventions and length of stay in hospital.Results:Seventeen patients, 14 male and 3 female, met inclusion criteria. Ages ranged from 8–17 years, with an average age of 13.7 years. Thirteen were <16 years of age. Overall there were 7 different systems injured in these 17 patients. Fourteen patients sustained an injury to more than 1 system. The average ISS was 22.8. The average length of hospital stay was 9.7 days. Six patients sustained significant head injuries; 4 of these 6 patients were not wearing helmets. Eight patients suffered splenic injuries, and 3 required a splenectomy. Thirteen patients sustained fractures.Conclusions:ATV trauma is a significant threat to the children in Southwestern Ontario. These results clearly support the Canadian Paediatric Society's recommendation that children <16 years of age should be prohibited from operating or riding on ATVs.

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An Overview of Amish Mortalities at a Level I Trauma Center

The American Surgeon ◽

10.1177/00031348211047218 ◽

2021 ◽

pp. 000313482110472

Author(s):

Madison E. Morgan ◽

Catherine Ting Brown ◽

Larissa Whitney ◽

Kelly Bonneville ◽

Lindsey L. Perea

Keyword(s):

Trauma Center ◽

Chart Review ◽

Trauma Registry ◽

Age Groups ◽

Retrospective Chart Review ◽

Trauma Patients ◽

Injury Patterns ◽

Level Of Evidence ◽

Trauma Mortality ◽

Level I

Background The Amish population is a unique subset of patients that may require a specialized approach due to their lifestyle differences compared to the general population. With this reasoning, Amish mortalities may differ from typical trauma mortality patterns. We sought to provide an overview of Amish mortalities and hypothesized that there would be differences in injury patterns between mortalities and survivors. Methods All Amish trauma patients who presented and were captured by the trauma registry at our Level I trauma center over 20 years (1/2000-2004/2020) were analyzed. A retrospective chart review was subsequently performed. Patients who died were of interest to this study. Demographic and clinical variables were analyzed for the mortalities. Mortalities were then compared to Amish patients who survived. Results There were 1827 Amish trauma patients during the study period and, of these, 32 (1.75%) were mortalities. The top 3 mechanisms of injury leading to mortality were falls (34.4%), pedestrian struck (21.9%), and farming accidents (15.6%). Pediatric (age ≤ 14y) (25%) and geriatric (age ≥ 65y) (28.1%) had the highest percentage of mortalities. Mortalities in the Amish population were significantly older (mean age: 39 years vs 27 years, P = .003) and had significantly higher ISS (mean ISS: 29 vs 10, P < .001) compared to Amish patients who survived. Discussion The majority of mortalities occurred in the pediatric and geriatric age groups and were falls. Further intervention and outreach in the Amish population should be done to highlight this particular cause of mortality. Level of Evidence Level III, epidemiological.

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