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Abbreviated Injury Scale (abbreviated + injury_scale)
Selected AbstractsShopping trolley-related injuries to children in New Zealand, 1988,97JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1 2002ML Parry Objective: To describe the epidemiology of shopping trolley related injuries (fatalities and hospitalizations) to children in New Zealand prior to the introduction of a voluntary standard for shopping trolleys. Methodology: To identify cases, a key word search was conducted of national mortality and hospitalization databases for the years 1988,97. Cases were limited to children under 15 years of age. Results: For the 10 year period investigated, 282 hospitalizations and no fatalities were identified. A significant increasing trend for hospitalizations was detected (,2 = 17.6, 1 d.f.; P < 0.001). Ninety-two per cent of children hospitalized were aged under 5 years and two-thirds were aged 2 years or younger. Ninety per cent of injuries resulted from falls from trolleys, 84% of injuries were to the head or face and 22% were rated serious (AIS-3) on the Abbreviated Injury Scale. Conclusions: The incidence of injuries associated with shopping trolleys increased between 1988 and 1997. Following the introduction of a voluntary standard for shopping trolleys in 1999, which included specifications for child harnesses, trends in injury should be monitored. [source] Patterns of Maxillofacial Injuries As a Function of Automobile Restraint Use,THE LARYNGOSCOPE, Issue 4 2000M. Scott Major MD Abstract Objective To determine the pattern and severity of maxillofacial injuries sustained in a motor vehicle accident (MVA) resulting from automobile restraint use. Design Retrospective database review of patients injured in a MVA who were admitted to the level I trauma center at the University of Louisville Hospital in Louisville, Kentucky. Methods Demographic data, drug and alcohol impairment screening, and comorbidity data were obtained from database searches of trauma records. Forty-four patients had an airbag deployed, 34 patients wore seat belts, and 94 patients were unrestrained. All maxillofacial Abbreviated Injury Scale (AIS) ratings were compared among the three groups. Results Twenty-two of the 44 patients (50%) in the airbag group sustained only facial injuries. Fifteen of them had lacerations; four others had only facial abrasions. Three of the airbag patients had moderate facial injuries (AIS = 2); none required operative management. The airbag group had a mean AIS rating of 1.13, the seat belt group a mean AIS of 1.29, and the unrestrained group a mean AIS of 1.46. Patients using either seat belts (mean age, 40.5 y) or airbags (mean age, 44.9 y) were older than the unrestrained group (mean age, 39.6 y). Drug and/or alcohol impairment was significantly greater in the unrestrained group (mean, 38%) compared with the seat belt group (mean, 26%) and the airbag group (mean 11%). Conclusions Use of airbags is associated with less severe maxillofacial injuries compared with either a seat belt alone or no restraint. There is an inherent risk of minor maxillofacial injuries with airbag usage, but the severity of injury is distinctly reduced. [source] Determinants of hospital costs associated with traumatic brain injury in England and Wales,ANAESTHESIA, Issue 5 2008S. Morris Summary Using data from the Trauma Audit Research Network, we investigated the costs of acute care in patients , 18 years of age hospitalised for traumatic brain injury between January 2000 and December 2005 in England and Wales. Traumatic brain injury patients were defined and stratified using the Abbreviated Injury Scale. A total of 6484 traumatic brain injury patients were identified; 22.3% had an Abbreviated Injury Scale score of three, 38.0% of four and 39.7% of five. Median age (IQR) was 42 years (28,59) and 76.7% were men. Primary cause of injury was motor vehicle collisions (42.4%) followed by falls (38.0%). In total 23.7% of the patients died before discharge. Hospitalisation costs averaged £15 462 (SD £16 844). Costs varied significantly by age, Glasgow Coma Score, Injury Severity Score, coexisting injuries of the thorax, spine and lower limb, hospital mortality, availability of neurosurgical services, and specialty of attendants seen in the Accident and Emergency department. [source] Management of spleen injuries: the current profileANZ JOURNAL OF SURGERY, Issue 3 2010Antonina Mikocka-Walus Abstract Background:, There has been a shift from operative to conservative management of splenic injuries in the last two decades, but the current practice in Australia is not known. This study aims to determine the profile of splenic injury in major trauma victims and the approach to treatment in Victoria for the last 2 years. Methods:, A review of prospectively collected data from the Victorian State Trauma Registry (VSTR) from July 2005 to June 2007 was conducted. Demographic data, details of the event, clinical observations, management and associated outcomes were extracted from the database. The patients were categorized into four groups according to management (conservative, splenectomy, embolization and repair) and were compared accordingly. Multivariate binary logistic regression was performed to identify predictors of treatment (conservative versus splenectomy) on arrival. Results:, Of the 318 major trauma patients with splenic injuries, 186 (59%) were treated conservatively, 103 (32%) with splenectomy, 17 (5%) with arterial embolization and 12 (4%) with repair. Of these, 14 (14%) splenectomy cases and 2 (12%) embolization cases did not receive their respective treatments within 24 h. The severity of the spleen injury (as measured by the Abbreviated Injury Scale (AIS)) and age were identified as significant independent predictors of the form of treatment provided. Conclusion:, In Victoria, conservative management is the preferred approach in patients with minor (AIS = 2) to moderate (AIS = 3) splenic injuries. The low rates of embolization warrant further research into whether splenectomy is overused. [source] The Impact of Injury Coding Schemes on Predicting Hospital Mortality After Pediatric InjuryACADEMIC EMERGENCY MEDICINE, Issue 7 2009Randall S. Burd MD Abstract Objectives:, Accurate adjustment for injury severity is needed to evaluate the effectiveness of trauma management. While the choice of injury coding scheme used for modeling affects performance, the impact of combining coding schemes on performance has not been evaluated. The purpose of this study was to use Bayesian logistic regression to develop models predicting hospital mortality in injured children and to compare the performance of models developed using different injury coding schemes. Methods:, Records of children (age < 15 years) admitted after injury were obtained from the National Trauma Data Bank (NTDB) and the National Pediatric Trauma Registry (NPTR) and used to train Bayesian logistic regression models predicting mortality using three injury coding schemes (International Classification of Disease-9th revision [ICD-9] injury codes, the Abbreviated Injury Scale [AIS] severity scores, and the Barell matrix) and their combinations. Model performance was evaluated using independent data from the NTDB and the Kids' Inpatient Database 2003 (KID). Results:, Discrimination was optimal when modeling both ICD-9 and AIS severity codes (area under the receiver operating curve [AUC] = 0.921 [NTDB] and 0.967 [KID], Hosmer-Lemeshow [HL] h-statistic = 115 [NTDB] and 147 [KID]), while calibration was optimal when modeling coding based on the Barell matrix (AUC = 0.882 [NTDB] and 0.936 [KID], HL h-statistic = 19 [NTDB] and 69 [KID]). When compared to models based on ICD-9 codes alone, models that also included AIS severity scores and coding from the Barell matrix showed improved discrimination and calibration. Conclusions:, Mortality models that incorporate additional injury coding schemes perform better than those based on ICD-9 codes alone in the setting of pediatric trauma. Combining injury coding schemes may be an effective approach for improving the predictive performance of empirically derived estimates of injury mortality. [source] Development and Validation of the Excess Mortality Ratio,adjusted Injury Severity Score Using the International Classification of Diseases 10th EditionACADEMIC EMERGENCY MEDICINE, Issue 5 2009Jaiyong Kim MD Abstract Objectives:, This study aimed to develop and validate a new method for measuring injury severity, the excess mortality ratio,adjusted Injury Severity Score (EMR-ISS), using the International Classification of Diseases 10th Edition (ICD-10). Methods:, An injury severity grade similar to the Abbreviated Injury Scale (AIS) was converted from the ICD-10 codes on the basis of quintiles of the EMR for each ICD-10 code. Like the New Injury Severity Score (NISS), the EMR-ISS was calculated from three maximum severity grades using data from the Korean National Injury Database. The EMR-ISS was then validated using the Hosmer-Lemeshow goodness-of-fit chi-square (HL chi-square, with lower values preferable), the area under the receiver operating characteristic curve (AUC-ROC), and the Pearson correlation coefficient to compare it with the International Classification of Diseases 9th Edition,based Injury Severity Score (ICISS). Nationwide hospital discharge abstract data (DAD) from stratified-sample general hospitals (n = 150) in 2004 were used for an external validation. Results:, The total number of study subjects was 29,282,531, with five subgroups of particular interest identified for further study: traumatic brain injury (TBI, n = 3,768,670), traumatic chest injury (TCI, n = 1,169,828), poisoning (n = 251,565), burns (n = 869,020), and DAD (n = 26,374). The HL chi-square was lower for EMR-ISS than for ICISS in all groups: 42,410.8 versus 55,721.9 in total injury, 7,139.6 versus 20,653.9 in TBI, 6,603.3 versus 4,531.8 in TCI, 2,741.2 versus 9,112.0 in poisoning, 764.4 versus 4,532.1 in burns, and 28.1 versus 49.4 in DAD. The AUC-ROC for death was greater for EMR-ISS than for ICISS: 0.920 versus 0.728 in total injury, 0.907 versus 0.898 in TBI, 0.675 versus 0.799 in TCI, 0.857 versus 0.900 in poisoning, 0.735 versus 0.682 in burns, and 0.850 versus 0.876 in DAD. The Pearson correlation coefficient between the two scores was ,0.68 in total injury, ,0.76 in TBI, ,0.86 in TCI, ,0.69 in poisoning, ,0.58 in burns, and ,0.75 in DAD. Conclusions:, The EMR-ISS showed better calibration and discrimination power for prediction of death than the ICISS in most injury groups. The EMR-ISS appears to be a feasible tool for passive injury surveillance of large data sets, such as insurance data sets or community injury registries containing diagnosis codes. Additional further studies for external validation on prospectively collected data sets should be considered. [source] | ||||||||||