When?

Where?

Questionnaire

SIR Data bank

1.

ST ID

Participant ID

2.

Alter

Age

3.

Anz. Frakturen

Number of fractures

4.

Lfd. Fraktur Nr.

0 = keine Angaben

Serial no. of fractures

0 = no information

5.

Erste Fraktur je ST

0 = nein
1 = ja

First fracture per participant

0 = no
1 = yes

6.

ICD-9 Code

0 = keine Fraktur

ICD-9 code

0 = no fracture

7.

Datum der Fraktur (Monat)

0 = keine Fraktur
1 = Januar
2 = Februar
3 = März
4 = April
5 = Mai
6 = Juni
7 = Juli
8 = August
9 = September
10 = Oktober
11 = November
12 = Dezember

Date of fracture (month)

0 = no fracture
1 = January
2 = February
3 = March
4 = April
5 = May
6 = June
7 = July
8 = August
9 = September
10 = October
11 = November
12 = December

8.

Datum der Fraktur (Jahr)

0 = keine Fraktur

Date of fracture (year)

0 = no fracture

9.

Beurteilung des Traumas

1 = ja
2 = fraglich
3 = nein

Trauma evaluation

1 = yes
2 = uncertain
3 = no

10.

Letzter Record pro ST

0 = nein
1 = ja

Last record per participant

0 = no
1 = yes