Contribution of Traumatology Registries for the Improvement of Care: Which Way Should France Take?

The establishment of a trauma network improves the efficiency of patient care. Trauma registries can be used to measure the effectiveness of the network, but also to adapt resources and guide health policies. However, the logistics of existing registers in other countries are complex and costly. In France, there is not yet a structured trauma network or a national trauma registry.The means available to evaluate trauma activity are limited: epidemiological surveys, road traffic accident registers, and severe regional trauma registries (eg TRENAU in the Northern Alps). The analysis of medical activity through the Program of Medicalization of Information Systems (PMSI) allows a global but limited vision of the importance of this activity. Therefore a study was conducted to illustrate the public health issue related to trunk trauma in France. The preliminary results are presented in this paper. Traumatic lesions of the trunk were present in 1% of patients hospitalized in medicine and / or surgery in 2015 (121,528 patients). Patients were treated in 56% of the cases in the General Hospital Center, 29% in the Regional and / or University Hospital Centers, and 15% in the private sector or equivalent. A passage in intensive care was necessary for 17% of the patients and mortality was 2.25%. A transfer to another medical structure was carried out in 29% of the cases. These partial data, as well as preliminary (such as Traumabase) or regional experiments, will allow the establishment of a formal trauma network at the national level with the establishment of an effective registry.