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External cause of injury codes can be extremely useful sources of morbidity data, but the quality of such coding varies from state to state (and from hospital to hospital). A new US report discusses the value of high-quality E-coding and provides recommendations to improve E-coding. This can be accomplished through better communication among stakeholders, enhancing the completeness and accuracy of E-coding, and presenting the data in useful ways for injury surveillance and prevention at local, state, and federal levels. CDC Workgroup for Improvement of External Cause-of-Injury Coding. Strategies to improve external cause-of-injury coding in state-based hospital discharge and emergency department data systems. MMWR Recommendations and Reports 2008:RR-1.

In the US, level I trauma centers are designated to provide the highest level of care. But when researchers at the University of Texas Southwestern Medical School examined the survival of patients at 47 centers through the National Trauma Data Bank, they found great differences among the centers. Even for mild injuries, survival rates at 11% of the centers were significantly worse than at the others. And as injury severity increased, the outcomes disparities increased as well, including among patient subgroups those with head injuries, with penetrating injuries and aged greater than 55. Shafi S, Friese …

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