NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide National Trauma Data Bank 2008 Annual Report Version 8.0

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide NTDB Annual Report 2008 Editors Avery B. Nathens, MD, FACS, ChairRichard J. Fantus, MD, FACS, Chair National Trauma Data Bank SubcommitteeTrauma Registry Advisory Ad Hoc Committee American College of Surgeons Committee on Trauma Leadership John J. Fildes, MD, FACSJ. Wayne Meredith, MD, FACS Chair, Committee on TraumaMedical Director, Trauma Office Division of Research and Optimal Patient Care National Trauma Data Bank Subcommittee Palmer Q. Bessey, MD, FACS Karen J. Brasel, MD, FACS David E. Clark, MD, FACS Arthur Cooper, MD, FACS Joseph Cuschieri, MD, FACS Richard J. Fantus, MD, FACS Jeffrey S. Hammond, MD, FACS Richard J. Kagan, MD, FACS Geoffrey R. Keyes, MD, FACS Michael D. McGonigal, MD, FACS Frederick H. Millham, MD, FACS Allen F. Morey, MD, FACS Charles E. Morrow, Jr., MD, FACS Michael L. Nance, MD, FACS Avery B. Nathens, MD, PhD, FACS Manoj R. Shah, MD, FACS Glen H. Tinkoff, MD, FACS N. Clay Mann, PhD, MS, Consultant National Trauma Data Bank Staff Melanie Neal, Manager Sandra Goble, Statistician Chrystal Price, Coordinator

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Acknowledgments The American College of Surgeons Committee on Trauma wishes to thank the Centers for Disease Control and Prevention (CDC) for their support of the NTDB.

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Please note: The abbreviation NK/NR used on many tables denotes Not Known, Not Recorded, or Blank. If Not Applicable is not shown as a separate row on the table, then it is also included in the NK/NR category. Local ISS denotes ISS scores submitted directly by hospitals regardless of the method of calculation. ICD90 Derived are scores derived by converting ICD9 codes to AIS using the ICD 90 Mapping program and then calculating ISS with the resulting AIS severity scores. AIS Derived are calculated from AIS submitted directly by hospitals. Analyses in this report use the ICD 90 Derived ISS.

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Percent of hospitals = Number of hospitals in the state that have submitted to the NTDB divided by the number of hospitals identified by the Trauma Exchange Information Program (TIEP) as trauma centers designated by a state or local authority and/or verified by the American College of Surgeons. States and U.S. Territories Submitting to the NTDB 67% or greater 34% to 66% 0% to 33% Figure 1

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Facilities by Bed Size Figure 2

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Facilities by Trauma Level Figure 3

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Facilities by Region Figure 4

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Age Figure 5A

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Age Figure 5B

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Age and Gender Figure 6A

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Age and Gender Figure 6B

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Alcohol Use Figure 7

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Drug Use Figure 8

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Primary Payment Source Figure 9

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Mechanism of Injury Figure 10A

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Mechanism of Injury Figure 11B

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Mechanism of Injury by Age Figure 11

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Mechanism of Injury and Age Figure 12

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Mechanism of Injury and Gender Figure 13A

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Mechanism of Injury and Gender Figure 13B

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Comparative Injury Severity Scores Figure 14

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Injury Severity Score Figure 15

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Injury Severity Score and Age Figure 16

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Injury Severity Score and Age Figure 17

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Work-Related Injuries Figure 18A

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Work-Related Injuries Figure 18B

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Intent Figure 19

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Location E-code Figure 20

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by AIS Body Region Note : An incident may involve multiple organ systems and a patient will then be counted in each of the organ systems in which there is an injury. Figure 21

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents with AIS 3 by AIS Body Region Note: An incident may involve multiple body regions, and, if so, the patient will be counted in each of the categories in which there is an injury. Figure 22

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by AIS Body Region Note : an incident may involve multiple body regions, and, if so, the patient will be counted in each of the categories in which there is an injury. Figure 23

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Protective Devices Figure 24

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Median Total EMS Length (Mins) by Mechanism of Injury Figure 25

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Median Total EMS Length (Mins) by Injury Severity Score Figure 26

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Median Length of Stay (Days) by Mechanism of Injury Figure 27

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Median Length of Stay (Days) by Injury Severity Score Figure 28

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Median Ventilator Days by Mechanism of Injury Figure 29

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Median Ventilator Days by Injury Severity Score Figure 30

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Median ICU Days by Mechanism of Injury Figure 31

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Median ICU Days by Injury Severity Score Figure 32

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by ED Discharge Disposition Figure 33

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Reasons for Death in Emergency Department Figure 34

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Hospital Discharge Disposition Figure 35

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Hospital Complications Figure 36

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Incidents by Region Figure 37

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Region Figure 38

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Mechanism of Injury by Region Figure 39

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Injury Severity Score by Region Figure 40

NTDB ® Annual Report 2008 © American College of Surgeons All Rights Reserved Worldwide Resources for more information about NTDBwww.ntdb.org to transmit data to NTDBwww.ntdbdatacenter.com for information on the new data standardwww.ntdsdictionary.org