Annual Meeting of the American Association for the Surgery of Trauma. Halifax, Nova Scotia (CAN), 1995/09/27.
The Injury Severity Score (ISS) has served as the standard summary measure of human trauma for 20 years.
Despite its stalwart service, the ISS has two weaknesses : it relies upon the consensus derived severity estimates for each Abbreviated Injury Scale (AIS) injury and considers, at most, only three of an individual patient's injuries, three injuries that often are not even the patient's most severe injuries.
Additionally, the ISS requires that all patients have their injuries described in the AIS lexicon, an expensive step that is currently taken only at hospitals with a zealous commitment to trauma care.
We hypothesized that a data driven alternative to ISS that used empirically derived injury severities and considered all of an individual patient's injuries would more accurately predict survival.
Survival risk ratios were derived for every International Classification of Disease 9th Edition (ICD-9) injury category (800-959.9) using the North Carolina State Discharge Database experience with 300,000 trauma patients over 5 years.
An ICD-9 Injury Severity Score (ICISS) was then defined as the product of all survival risk ratios for an individual patient's traumatic ICD-9 codes.
We compared the performance of ISS and ICISS in a group of 3,142 patients accrued at the University of New Mexico Trauma Center over 4 years.
These patients had both AIS and ICD-9 descriptors meticulously assigned prospectively by designated trauma data base personnel. (...)
Mots-clés Pascal : Traumatisme, Homme, Pronostic, Mortalité, Méthode mesure, Modèle, Indice gravité, International Classification of Diseases 9, Echelle évaluation, Valeur prédictive, Epidémiologie, Registre, Caroline du Nord, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Trauma, Human, Prognosis, Mortality, Measurement method, Models, Severity score, International Classification of Diseases 9, Evaluation scale, Predictive value, Epidemiology, Register, North Carolina, United States, North America, America
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0066546
Code Inist : 002B16N. Création : 21/05/1997.