Annual Report 2017: ICD-10

The 2017 Annual Report of the National Trauma Data Bank^® (NTDB^®) provides an updated analysis of the largest aggregation of U.S trauma registry data ever assembled. In total, the NTDB now contains more than 8 million records. The 2017 Annual Report is based on 968,842 records with valid trauma diagnoses from the single admission year of 2016; in all, 765 facilities submitted records. These facilities include 239 Level I trauma centers, 288 Level II trauma centers, and 204 Level III or IV trauma centers; 27 are Level I or Level II pediatric-only centers.

Transition to ICD-10

The International Classification of Diseases (ICD), owned and published by the World Health Organization, is the world-standard diagnostic tool for health management, epidemiology, and clinical purposes. The ICD is used to monitor incidence and prevalence of diseases and other health care conditions.* In 2009, the U.S. Department of Health and Human Services published a regulation requiring U.S. providers to transition from the ninth edition of the classification system (ICD-9) to what the rest of the world was using—ICD-10.

ICD-10 has several specific advantages over its predecessor. Some trauma-related highlights include expanded injury codes, a combination of diagnosis/symptom codes to reduce the number of codes necessary to describe a condition, and two additional characters added along with subclassifications, allowing laterality and greater specificity in code assignment. The 2017 Annual Report uses admission year 2016 records, and 95 percent of those records containing valid ICD codes are reported with ICD-10 nomenclature (see Table 1 for a comparison of ICD-9 and ICD-10 code sets).

Table 1. Differences between ICD-9-CM and ICD-10-CM code sets

Purpose of Annual Report

The mission of the American College of Surgeons (ACS) Committee on Trauma (COT) is to develop and implement meaningful programs for trauma care. In keeping with this objective, the NTDB is committed to being the principal national repository for trauma center data. The purpose of this report is to inform the medical community, the public, and decision makers about a variety of issues that characterize the current state of care for injured persons. It has implications in many areas, including epidemiology, injury control, research, education, acute care, and resource allocation.

Many dedicated individuals on the ACS COT, as well as at trauma centers around the country, have contributed to the early development of the NTDB and its rapid growth in recent years. Building on these achievements, the goals in the coming years include improving data quality, updating analytic methods, and enabling more useful interhospital comparisons. These efforts will be reflected in future NTDB reports to participating hospitals, as well as in the annual reports.

Throughout the year, we will be highlighting these data through brief monthly reports in the Bulletin. All previous years of the NTDB Annual Report are available on the ACS website as a PDF file. In addition, information is available on the website regarding how to obtain NTDB data for more detailed study. If you are interested in submitting your trauma center’s data, contact Melanie L. Neal, Manager, NTDB, at mneal@facs.org.

Acknowledgement

Statistical support for this article was provided by Ryan Murphy, Data Analyst, NTDB.

*World Health Organization. Classifications. Available at: www.who.int/classifications/icd/en/. Accessed November 5, 2017.