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J Trauma Inj. 2017 Dec;30(4):126-130. English. Original Article. https://doi.org/10.20408/jti.2017.30.4.126
Park CY , Lee KH , Lee NY , Kim SJ , Cho HM , Lee CK .
Department of Trauma Surgery, Pusan National University Hospital, Busan, Korea. apolo1980@hanmail.net
Department of Orthopedic Surgery, National Medical Center, Seoul, Korea.
Trauma Center, Pusan National University Hospital, Busan, Korea.
Abstract

Purpose

Preventable Trauma Death Rate (PTDR) using Trauma and Injury Severity Score (TRISS) has been most widely used as a quality indicator in South Korea. However, this method has a small number of deaths corresponding to the denominator. Therefore, it is difficult to check the change of quality improvement for annual mortality, and there is a disadvantage that variation is severe. Therefore, we attempted to improve the quality of the mortality evaluation by reducing the variation by applying the PARK Index (preventable major trauma death rate, PMTDR) which can increase the number of denominator significantly. And the Save score (S-score) was also examined as another quality indicator.

Methods

In the PARK Index, the denominator is number of all patients who have survival probability (Ps) larger than 0.25. Numerator is the number of deaths among these. The PARK Index includes only patients with ISS >15. The S-score is calculated in the same way as the W-score, but the S-score includes only patients with ISS >15, which is a difference from the W-score.

Results

PARK Index decreased annually and was 12.9 (37/287) in 2014, 9.6 (33/343) in 2015, and 7.3 (52/709) in 2016. S-score increased annually and was −0.29 in 2014, 4.21 in 2015, and 8.75 in 2016.

Conclusions

PARK Index and S-score improved annually. This shows that both quality indicators are improving year by year. PARK Index (PMTDR) has 9.5-fold increase in denominator overall compared to PTDR by TRISS. The S-score used only ISS >15 patients as a denominator. Therefore, there is an advantage that the numerical value change is larger than the W-score. In addition, S-score is not affected by the ratio of major trauma patients to minor trauma patients.

Copyright © 2019. Korean Association of Medical Journal Editors.