Dados do Trabalho

Título

Trauma care benchmarking in Latin America – is it worth to analyze and compare in low-income countries?

Objetivo

To verify if the standard mortality ratio (SMR) is a good surrogate for benchmarking hospitals specialized in trauma care in Latin America.

Métodos

Retrospective cohort which took place in a trauma hospital in northeast Brazil. We included adult patients admitted to intensive care units (ICU) and calculated the ratio of the observed hospital mortality and the predicted hospital mortality – the SMR - during a period of a year. We used SAPS 3 and APACHE II scores to estimate the predicted mortality rate of our sample. Patients were followed up until hospital discharge or death. Statistical analysis was carried out using descriptive statistics with categorical variables being reported as counts and percentages, and continuous variables as means with standard deviations.

Resultados

210 patients were included. Mean SAPS 3 score was 62 (SD ±2.43) and the mean APACHE II was 14.3 (SD ±3.2). SMR using SAPS 3, in general and adjusted for Latin America, was 0.6 and 0.5, respectively, and SMR using APACHE II was 1.2. Our cohort real absolute mortality was 35%.

Conclusão

One of the many uses of SMR is to compare ICUs and evaluate local outcomes. In our cohort, SMS using SAPS3 and APACHE II scores denotated dichotomous quality of care results. Therefore, more studies are needed, aiming to adequately conclude best scoring systems for SMR.