%0 Journal Article %T A benchmarking study of two trauma centres highlighting limitations when standardising mortality for comorbidity %A Henry R Budd %A Laurence M Almond %A Peter A Oakley %A Gilbert McKenzie %A Peter Danne %J World Journal of Emergency Surgery %D 2008 %I BioMed Central %R 10.1186/1749-7922-3-2 %X Trauma patients with an Injury Severity Score (ISS) >15 admitted to the two centres in 2001 and 2002 were included in the study with the exception of those who died in the emergency department. Patient characteristics were analysed in terms of 18 case-mix factors including Glasgow Coma Scale on arrival, Injury Severity Score and the presence or absence of 9 co-morbidity types, and patient outcome was compared based on in-hospital mortality before and after standardisation.Crude mortality was greater at UHNS (18.2 vs 14.5%) with a non-significant odds ratio of 1.31 prior to adjusting for case-mix (P = 0.171). Adjustment for case mix using logistic regression analysis altered the odds ratio to 1.64, which was not significant (P = 0.069).This study did not demonstrate any significant difference in the outcome of patients treated at either hospital during the study period. More importantly it has raised several important methodological issues pertinent to researchers undertaking registry based benchmarking studies. Data at the two registries was collected by personnel with differing backgrounds, in formats that were not completely compatible and was collected for patients that met different admissions criteria. The inclusion of a meaningful analysis of pre-existing disease was limited by the availability of robust data and sample size. We suggest greater communication between trauma research coordinators to ensure equivalent data collection and facilitate future benchmarking studies.The outcome of trauma patients managed by individual centres is influenced by multiple factors including investment in the trauma service infrastructure, the facilities, technology and experience available at each centre, the type of injuries sustained and the background demographics of the patients managed. The performance of trauma centres has been evaluated by comparing outcomes with norms derived from pooled datasets, as in TRISS analysis and its modifications, and by benchmarking studie %U http://www.wjes.org/content/3/1/2