The regional

Hospital ACP-196 concentration discharge Registry (HDR), a part of the national HDR, includes the discharge forms of all hospitalised patients of the region since 2001. A common minimum data set, including demographics, place of residency, hospital length of stay (LOS), wards of admission or transit, discharge diagnoses, therapeutic procedures, and outcome, is adopted for all of the public or private hospitals partially or totally financed by the Regional Health Service (97% of existing hospitals). In HDR discharge diagnoses (one principal and up to five secondary diagnoses) and procedures are coded using the Clinical Modification of the International Classification of Diseases 9th edition (ICD-9-CM). In-hospital deaths are all recorded in HDR. Reimbursement of public or private hospitals Selleck Dabrafenib is calculated by Government of the Region using the disease-related group (DRG) system and the discharge form of HDR is the administrative document used to calculate the DRG: each patient

is weighted on the sequence of ICD-9-CM diagnoses, buy BMS345541 therapeutic procedures, complications and associated morbidities and the value of assigned DRG is reimbursed to the hospital. Data extraction To conduct this study all hospital admissions in Lombardia during a period of three years, from 2008 to 2010, have been reviewed. The aim was to select from regional HDR all patients who suffered from serious injuries. All patients with at least one principal

or secondary diagnosis coded from 800.0 to 939.9 or from 950.0 to 959.9 have been considered. Burns, scalds and frostbites, chemical corrosion, poisoning, intoxication, drowning and hangman, suffocation, ADAMTS5 electrocution, radiation and medical treatment complications, have been excluded. Furthermore, femur fractures (820.0 and 821.9), as the only traumatic diagnosis, have been considered only if affecting people younger than 65, to exclude femur fractures of elderly due to osteoporotic complications. All patients have been coded with an individual number. Patients with the first admission in a rehabilitation or spinal unit, with a LOS less than two days, unless discharged dead or transferred from or to other facilities, have been excluded. To select seriously injured any of the following criteria have been used:  patients discharged dead  patients admitted in intensive care unit (ICU) during the course of hospital stay  patients which have been mechanically ventilated (ICD9 code 96.70-96.72) or received tracheotomy (31.1-31.29)  patients which received invasive hemodynamic monitoring (89.60-89.69) All patients with at least one of these characteristics have been classified as serious trauma and included in the analysis. Distribution of severe trauma for specific age-sex population groups has been estimated.