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

2. NTDB ® Annual Report 2008 © American College of Surgeons 2008. 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

3. NTDB ® Annual Report 2008 © American College of Surgeons 2008. 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.

4. NTDB ® Annual Report 2008 © American College of Surgeons 2008. 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.

5. NTDB ® Annual Report 2008 © American College of Surgeons 2008. 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

30. NTDB ® Annual Report 2008 © American College of Surgeons 2008. 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

31. NTDB ® Annual Report 2008 © American College of Surgeons 2008. 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

32. NTDB ® Annual Report 2008 © American College of Surgeons 2008. 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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