An Analysis of Surgical Procedures for Trauma from the National Clinical Database in Japan, 2011–2016

Thenumber of general surgeons has decreased owing to specialization in the surgical field. Moreover, interest in the development of acute care surgeons is increasing. It is estimated that not many trauma surgical procedures are sufficient to train acute care surgeons in Japan. However, the actual status of trauma surgery in Japan remains unclear. This study aimed to clarify the actual condition of trauma surgery in Japan and to examine measures for training acute care surgeons and improving surgical outcomes. We analyzed trauma surgical procedures registered in the National Clinical Database between 2011 and 2016. The annual number of surgical procedures performed for trauma in the National Clinical Database increased. The surgical procedures for trauma accounted for only 3% of all National Clinical Database registrations. Moreover, the number of trauma surgical procedures for acute care surgery-certified surgeons in Japan was only 0.3%. Average mortality and morbidity rates were 8.3% and 22.5%, respectively. To train acute care surgeons and improve surgical outcomes, it is necessary to aggregate patients with severe trauma to designated facilities with trauma centers. We propose that National Clinical Database should be reformed to enable data collection and analysis of trauma surgery, including anatomical and physiological severity.