This repository includes the manuscript and code for the research project on opportunities for improvement in the care of adult trauma patients arriving in shock.
Trauma - physical injury and the body’s associated response - is a major cause of death and disability worldwide. Every year, over four million people die from trauma, and it is the top cause of burden of disease in young people. Trauma quality improvement programmes aim to identify opportunities for improvement in the care of trauma patients, and to implement changes to improve patient outcomes. The initial management of trauma patients once they reach hospital is very time sensitive and error prone, especially in patients arriving in shock. Little is known however about the specific types of opportunities for improvement that are present in the care of these patients.
This study aims to describe opportunities for improvement adult trauma patients arriving in shock, and to assess how the degree of shock is associated with opportunities for improvement.
This is a registry based cohort study using data from the trauma registry and trauma care quality database at the Karolinska University Hospital in Solna. The trauma registry includes about 14000 patients treated between 2012 and 2023. The trauma care quality database is a subset of the trauma registry and includes about 8000 patients selected for review between 2014 and 2023. The outcome is opportunities for improvement, such as delayed management or technical errors, as identified by a multidisciplinary trauma quality improvement review board and recorded in the trauma care quality database. This project will link the two databases and assess what types of OFI occurred in patients arriving in shock and use adjusted logistic regression to assess the association between the degree of shock and odds of opportunities for improvement. A 5% significance level and 95% confidence levels will be used.