NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide National Trauma Data Bank 2010 Annual Report

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide 67% or greater 34% to 66% 0% to 33% Percent of Hospitals Submitting Data to NTDB by State and US Territory Figure 1 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 of local authority and/or verified by the American College of Surgeons.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Facilities by Bed Size Figure 2

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 3 Facilities by Trauma Level

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 4 Facilities by Region

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 5 Facilities by ICD-9 Inclusion Criteria

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 6 Facilities by Length of Stay Inclusion Criteria

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 7 Facilities by Isolated Hip Fracture Inclusion Criteria by Age

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 8 Facilities by Death on Arrival (DOA) Inclusion Criteria

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 9 Incidents by Age

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 10 Case Fatality Rate by Age

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 11 Incidents by Age and Gender

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 12 Case Fatality Rate by Age and Gender

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 13 Alcohol Use

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 14 Drug Use

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 15 Primary Payment Source

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 16A Incidents by Selected Mechanisms of Injury

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 16B Case Fatality Rate by Selected Mechanisms of Injury

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 17 Incidents by Selected Mechanisms of Injury and Age

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 18 Case Fatality Rate by Selected Mechanisms of Injury and Age

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 19A Incidents by Selected Mechanisms of Injury and Gender

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 19B Case Fatality Rate by Selected Mechanisms of Injury and Gender

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 20 Incidents by Comparative Injury Severity Scores

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 21 Case Fatality Rate by Injury Severity Score

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 22 Injury Severity Score by Age

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Figure 23 Case Fatality Rate by Injury Severity Score and Age

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Incidents by Work-Related Injuries Figure 24A

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Work-Related Injuries Figure 24B

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Intent Figure 25

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Location E-code Figure 26

NTDB ® Annual Report 2010 © 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 27

NTDB ® Annual Report 2010 © 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 28

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate for AIS > 3 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 29

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Incidents by Protective Devices Figure 30

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Median Total Prehospital (in Minutes) by Selected Mechanisms of Injury Figure 31

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Median Total Prehospital Time (in Minutes) by Injury Severity Score Figure 32

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Median Length of Stay (in Days) by Selected Mechanisms of Injury Figure 33

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Median Length of Stay (in Days) by Injury Severity Score Figure 34

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Median Ventilator Days by Selected Mechanisms of Injury Figure 35

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Median Ventilator Days by Injury Severity Score Figure 36

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Median ICU Days by Mechanism of Injury Figure 37

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Median ICU Days by Injury Severity Score Figure 38

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Incidents by ED Discharge Disposition Figure 39

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Reasons for Death in Emergency Department Figure 40

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Incidents by Hospital Discharge Disposition Figure 41

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Incidents by Region Figure 42

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Region Figure 43

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Mechanism of Injury by Region Figure 44

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Injury Severity Score by Region Figure 45

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Incidents by Rurality Figure 46

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate by Rurality Figure 47

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Mechanism of Injury by Rurality Figure 48

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Injury Severity Score by Rurality Figure 49

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Number of Cases Submitted per Facility for Level I Facilities Figure 50 Only cases with valid trauma diagnosis code per the NTDB criteria are included in the analysis. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Number of Cases Submitted per Facility for Level II Facilities with Bed Size Less than or Equal to 400 Beds Figure 51 Only Cases with valid trauma diagnosis code per the NTDB criteria are included in the analysis. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Number of Cases Submitted per Facility for Level II Facilities with Bed Size Greater than 400 Beds Figure 52 Only cases with valid trauma diagnosis code per the NTDB criteria are included in the analysis. Trauma level is based upon ACS verification and state designation; however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Number of Cases Submitted per Facility for Level III Facilities Figure 53 Only Cases with valid trauma diagnosis code per the NTDB criteria are included in the analysis. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Number of Cases Submitted per Facility for Level IV Facilities and Facilities with Designation Other or Not Applicable Figure 54 Only Cases with valid trauma diagnosis code per the NTDB criteria are included in the analysis. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate per Facility for Level I Facilities Figure 55 One facility out of the 194 level I facilities had a case fatality rate of 0% reported and is therefore not visible on the graph. All deaths including Dead on Arrival are included in the analysis. Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate per Facility for Level II Facilities with Bed Size Less than or Equal to 400 Beds Figure 56 Three out of the 137 facilities had a case fatality rate of 0% reported and are therefore not visible on the graph. All deaths including Dead on Arrival are included in the analysis. Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate per Facility for Level II Facilities with Bed Size Greater than 400 Beds Figure 57 One facility out of the 80 level II facilities had a case fatality rate of 0% reported and is therefore not visible on the graph. All deaths including Dead on Arrival are included in the analysis. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate per Facility for Level III Facilities Figure 58 Four facilities out of the 121 level II facilities had a case fatality rate of 0% reported and is therefore not visible on the graph. All deaths including Dead on Arrival are included in the analysis. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Case Fatality Rate per Facility for Level IV Facilities and Facilities with Designation Other or Not Applicable Figure 59 Thirty-seven facilities out of the 131 facilities had a case fatality rate of 0% reported and is therefore not visible on the graph. All deaths including Dead on Arrival are included in the analysis. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Percentage of Cases with ISS 16 per Facility for Level I Facilities Figure 60 The ISS score calculated for all records are based on the ICD-90 map. Trauma level is based upon ACS verification and state designation; however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Percentage of Cases with ISS 16 per Facility for Level II Facilities with Bed Size Less than or Equal to 400 Beds Figure 61 The ISS score calculated for all records are based on the ICD-90 map. Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Percentage of Cases with ISS 16 per Facility for Level II Facilities with Bed Size Greater than 400 Beds Figure 62 The ISS score calculated for all records are based on the ICD-90 map. Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Percentage of Cases with ISS 16 per Facility for Level III Facilities Figure 63 The ISS score calculated for all records are based on the ICD-90 map. Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Percentage of Cases with ISS 16 per Facility for Level IV Facilities and Facilities with Designation Other or Not Applicable Figure 64 Thirteen out of 131 facilities had no incidents with ISS 16, and are therefore not visible on the graph. The ISS score calculated for all records are based on the ICD-90. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Data Completeness per Facility for Level I Facilities Figure 65 An incident was classified as not complete if any of the following key variables were not known/not documented: Age, Gender, Primary E-Code, Locally submitted Injury Severity Score, ED/Hospital Discharge Disposition, and Length of Stay. Trauma level is based upon ACS verification and state designation; however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Data Completeness per Facility for Level II Facilities with Bed Size Less than or Equal to 400 Beds Figure 66 One out of 137 facilities had 0% of the incidents complete, and is therefore not visible on the graph. An incident was classified as not complete if any of the following key variables were not known/not documented: Age, Gender, Primary E- Code, Locally submitted Injury Severity Score, ED/Hospital Discharge Disposition, and Length of Stay. Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Data Completeness per Facility for Level II Facilities with Bed Size Greater than 400 Beds Figure 67 An incident was classified as not complete if any of the following key variables were not known/not documented: Age, Gender, Primary E-Code, Locally submitted Injury Severity Score, ED/Hospital Discharge Disposition, and Length of Stay. Trauma level is based upon ACS verification and state designation; however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Data Completeness per Facility for Level III Facilities Figure 68 Nine out of 121 facilities had 0% of the incidents complete, and are therefore not visible on the graph. An incident was classified as not complete if any of the following key variables were not known/not documented: Age, Gender, Primary E-Code, Locally submitted Injury Severity Score, ED/Hospital Discharge Disposition, and Length of Stay. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Data Completeness per Facility for Level IV Facilities and Facilities with Designation Other or Not Applicable Figure 69 Thirteen out of 131 facilities had 0% of the incidents complete, and are therefore not visible on the graph. An incident was classified as not complete if any of the following key variables were not known/not documented: Age, Gender, Primary E-Code, Locally submitted Injury Severity Score, ED/Hospital Discharge Disposition, and Length of Stay. Trauma level is based upon ACS verification and state designation.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Complications Reported per Facility for Level I Facilities Figure 70 Two out of 194 facilities had 0% of the incidents with valid response for hospital complications, including not applicable, and are therefore not visible on the graph. Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Complications Reported per Facility for Level II Facilities with Bed Size Less than or Equal to 400 Beds Figure 71 Three out of 137 facilities had 0% of the incidents with valid response for hospital complications, including not applicable, and are therefore not visible on the graph. Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Complications Reported per Facility for Level II Facilities with Bed Size Greater than or Equal 400 Beds Figure 72 Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Complications Reported per Facility for Level III Facilities Figure 73 Three out of 121 facilities had 0% of the incidents with valid response for hospital complications, including not applicable, and are therefore not visible on the graph. Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Complications Reported per Facility for Level IV Facilities and Facilities with Designation Other or Not Applicable Figure 74 Trauma level is based upon ACS verification and state designation, however, pediatric hospitals are not included in the analysis.

NTDB ® Annual Report 2010 © American College of Surgeons All Rights Reserved Worldwide Resources for more information about NTDBwww.ntdb.org to submit data to NTDBwww.ntdbdatacenter.com for information on the data standardwww.ntdsdictionary.org