Showing papers on "Abbreviated Injury Scale published in 1986"

Predicting posttrauma functional disability for individuals without severe brain injury.

Abstract: The utility of the Abbreviated Injury Scale (AIS), the most widely used anatomic scale for rating severity of injuries, and its derivative for assessing the combined effect of multiple injuries, the Injury Severity Score (ISS), were tested for their ability to predict functional disability at time of discharge from the hospital and 6 months after discharge. The ISS has been shown to correlate well with mortality and length of stay, but the relationship to levels of subsequent disability has not been examined. Five hundred and ninety-seven patients (aged 16-45 years) were interviewed at time of discharge and 6 months after discharge to ascertain functional disability along three dimensions: activities of daily living (ADL), instrumental activities of daily living (IADL), and mobility. The authors report on the relationship between severity and functional disability at time of discharge and 6 months after discharge for a subset of 473 patients who did not suffer a severe brain injury. The results show that the relationship between ISS and status at discharge and 6 months after discharge is not monotonically increasing, as it is with mortality and length of stay (LOS). Rather, the proportion of people with severe injuries who report limitations is lower than for those with moderately severe injuries as defined by the ISS. Further, it is shown that the AIS of the most severe extremity and spinal cord injury carry considerably more weight when predicting functional status at discharge and 6 months after discharge than do the AIS scores of injuries to any other body region, although the relative explanatory power of each type of injury varies with the nature of the functional disability and the time interval between the initial insult and assessment.

An ICD-9CM to AIS conversion table: Development and application

Abstract: This paper describes a computerized conversion table which maps discharge diagnoses coded using the Clinical Modification of the 9th Revision of the International Classification of Diseases (ICD-9CM) into 1985 Abbreviated Injury Scale (AIS) scores. The development of the table is described in detail with major assumptions used in conversion of ICD to AIS discussed. In consultation with the AAAM Injury Scaling Committee, 1948 of the 2072 injury related ICD-9CM rubrics were assigned valid AIS scores between 1 and 6. The remaining 124 rubrics were assigned AIS scores of 9, either because the ICD description lacked sufficient qualifying information for determining severity or because injuries of very different levels of severity were incorporated within a single diagnostic rubric. The application of the conversion system using uniform hospital discharge abstract data is illustrated by two examples relevant to the management and evaluation of regionalized trauma systems.

Long term disability following road traffic accidents

Abstract: The extent to which individuals involved in road traffic accidents suffer long term disability has been inadequately researched. There is insufficent knowledge about the duration of any such disability, the effect on post-accident routine or the cost to the community. Furthermore little is known about the relationship, if any, between the duration or severity of disability and the severity or type of the initial injury. This report describes work which aimed to determine whether there is any correlation between injury severity and subsequent disability, whether such disability was a consequence of particular injuries and whether the effects of long term disability should be included when costing road accidents. It was concluded that up to 24 per cent of all patients who had been involved in a road traffic accident developed a disability which lasted at least six months. The commonly used Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) were found to be of little value in predicting the development of a disability. Only 28 per cent of patients with a residual disability were admitted to hospital, so that the examination of in-patient data alone would be likely to underestimate significantly the number of disabilities resulting from road accidents. Those injuries associated with the highest incidence of long-term disability were soft tissue injuries to the cervical spine ('whiplash' injuries) and closed fractures of the lower limbs. Present methods of costing road accidents which take account principally of in-patient costs are likely to underestimate their true cost. Further work on injuries resulting in a high incidence of disability and into the cost of out-patient resources is suggested. (TRRL)

One Year's Incidence of School Accidents and Their Severity in a Swedish Municipality

Abstract: The aim of this one-year investigation of school accidents was to determine the incidence and severity and to calculate the proportion of school accident cases in relation to all accident cases and to estimate their medical care consumption. All patients were interviewed. The degree of severity was evaluated according to the Abbreviated Injury Scale (AIS). Case-histories and X-ray reports were examined. School accidents constituted five per cent of all accidents in the whole population (including grown ups). In the age group 7–19 years 30 % of all accidents were school accidents. One fourth was relatively severe. Our estimations assume that school accidents constitute 5–10 % of the total consumption of medical care in the age group. In conclusion, school accidents constitute an important group with regard to incidence and severity. Preventive measures should be targeted towards activities during sports hours and breaks.

Motor vehicle accidents in northeastern Ontario: are preadmission deaths inevitable?

Abstract: A large proportion of deaths associated with motor vehicle accidents occur before the victim arrives at hospital. To determine whether these deaths are inevitable, we reviewed the autopsy records of 279 such patients in the Sudbury, Ont., region. The score on the abbreviated injury scale (1980 revision) was calculated for each case; 160 patients had a score of 6 (single fatal injuries) and were excluded from the study. The remaining 119 patients were considered to have had some potential for survival. The main injuries contributing to death were hemorrhage, airway dysfunction, pulmonary contusions and head injuries. Of the 119, 60 had evidence of central nervous system (CNS) injury. The mean injury severity scores (ISSs) for those with and without CNS injury were 37.3 and 33.3 respectively. Of the 64 patients with an ISS of 40 or less, 52 were judged to have had a likelihood of survival if improved trauma care before admission to hospital had been available in the Sudbury region.

Acute Injury Scaling Related to Residual Disability

Abstract: Injury scaling is an important issue in the traffic safety field. A comparison was made between the severity of injuries as graded according to the Abbreviated Injury Scale (AIS) and the severity 5 years after the accident. It was found that among persons with permanent medical disability ≥ 10%, 20% were given an AIS score of 1, i.e. they were initially judged as having a slight injury. This implies that the AIS scale needs to be re-evaluated to take into account possible long-term consequences.

Disabilities caused by road traffic accidents and their relation to severity scores

Abstract: The disabilities incurred by 2502 road accident patients admitted in three separate years to an Accident Hospital have been analysed. There were about equal numbers of disabled among pedestrians, motorcyclists and vehicle occupants. This corresponds to the high relative frequency and severity of injuries among motorcyclists. Most of the serious disabilities were caused by head or lower limb injuries. Different severities of disability were not closely correlated with Abbreviated Injury Scale (AIS), (ISS) or (PI) scores or with treatment periods but useful threshold values are described which separate groups with high and low rates of disability. For given severities of injury, disabilities were less severe among young casualties. Comparisons with other studies show rather wide variations in estimates of the incidence of slight disabilities. There is fair agreement with the present findings that serious disabilities occur in about 3% of inpatient hospital cases or in about 1% of total casualties.