Showing papers on "Abbreviated Injury Scale published in 1994"
TL;DR: The data suggest that aggressive resuscitation of these patients and treatment of extrapelvic injuries in conjunction with early or delayed ORIF, without application of acute external fixation, resulted in a low overall mortality rate.
Abstract: The management of hemodynamically unstable patients with displaced pelvic ring fractures and associated abdominal, thoracic, or head injuries is controversial. We studied 312 consecutive trauma patients with pelvic fractures admitted from July 1, 1989 through June 30, 1993: thirty-six of these patients were in shock (SBP ≤90 mm Hg) and were treated by a protocol including volume resuscitation, and treatment of the associated injuries, without use of acute external fixation. Evaluation of the pelvic fractures revealed 39% to be rotationally unstable; 61% were both rotationally and vertically unstable. The mean Injury Severity Score was 27±12, the average Glasgow Coma Scale score was 12±5, and the Abbreviated Injury Scale (AIS) scores stratified for the abdomen and the thorax were 1.9±1.7 and 1.6±1.8, respectively
143 citations
TL;DR: Results provide strong validation for the use of duration of posttraumatic amnesia, measured by the COAT, as a measure of TBI severity and a significant indicator of neurobehavioral and functional outcome in children.
72 citations
TL;DR: It is found that study children were more likely than children from the general population to have limitations in physical health, behavioral problems, and to be enrolled in a special education program.
Abstract: OBJECTIVES: To examine the consequences of head injury and the medical, economic, and sociodemographic factors affecting functional status 1 year after injury. METHODS: A follow-up was conducted on 95 children (aged 5 to 15) 1 year after they were hospitalized for head injury. Parents were interviewed by phone concerning their child's preinjury and current health status, and the family's economic and social resources during the 1 year postinjury. Inpatient medical records were reviewed to obtain information regarding the characteristics of the injury. RESULTS: We found that study children were more likely than children from the general population to have limitations in physical health, behavioral problems, and to be enrolled in a special education program. These findings were true for all levels of head injury severity, although children with severe head injuries (Abbreviated Injury Scale 5) were more likely to demonstrate these functional limitations than were children with less severe injuries (Abbreviated Injury Scale 2, 3, 4). After controlling for head injury severity, we found that the poorer outcomes were associated with poverty, preinjury chronic health problems, and lower extremity injuries. CONCLUSIONS: The large proportion of children who demonstrated functional limitations underscores the importance of evaluating all children hospitalized with head injuries for functional limitations and providing rehabilitation and social services when needed. Language: en
68 citations
TL;DR: During a 1-year period 100 badminton players were registered and treated in the casualty ward of Randers City Hospital, Denmark, they constituted 5% of all sports injuries registered during the same period in the accident and emergency ward.
Abstract: During a 1-year period 100 badminton players were registered and treated in the casualty ward of Randers City Hospital, Denmark. The injuries to the badminton players constituted 5% of all sports injuries registered during the same period in the casualty ward. At follow-up questionnaires were sent to all participants. Replies were received from 89 patients. Over the same period all sports participants in the hospital catchment area (30,254) were registered according to their sport affiliation (2620 badminton players-1650 men and 970 women). Of those injured 58% were men (mean age 31 years) and 42% were women (mean age 25 years). Of the injuries 55% occurred in club players, the remainder occurring during company and school sports activities. The active players were classified into three groups according to age: Group 1 under 18 years (31%); Group 2 18-25 years (16%); Group 3 more than 25 years (53%). According to the Abbreviated Injury Scale (AIS) 17% of the injuries were classified as minor, 56% as moderate, and 27% as severe, respectively. Of the severe injuries (AIS = 3) 56% were found in the oldest age group. AIS correlated with time absent from sport (P < 0.001). Nine players (9%) reported that earlier injuries had influenced the actual accident. Most players (96%) trained one to three times a week. Sprains were the injury most commonly diagnosed (56%), fractures accounted for 5%, torn ankle ligaments were found in 10%, and 13% had ruptures to the Achilles tendon. Overall, 21% were admitted to hospital. None of the patients treated as inpatients was kept in hospital for more than 7 days. The injury caused 56% of players to be absent from work of whom 23% were absent for more than 3 weeks. After the injury 12% of the players gave up their sport, and only 4% restarted their training/sport within 1 week. As many as 28% had to avoid training and playing in matches for 8 weeks or more.
67 citations
01 Nov 1994
TL;DR: Using cadaveric specimens, sixty-three simulated frontal impacts were performed to examine and quantify the performance of various contemporary automotive restraint systems.
Abstract: Using cadaveric specimens, sixty-three simulated frontal impacts were performed to examine and quantify the performance of various contemporary automotive restraint systems To characterize the mechanical responses during the impact, test-specimens were instrumented with accelerometers and chest bands The resulting thoracic injury severity was determined using detailed autopsy and was classified using the Abbreviated Injury Scale
63 citations
TL;DR: The study concluded that work is required to further define occupants most at risk, and comparisons were made with two studies into other types of injury at other body regions, and injuries rated AIS > or = 2 caused by seat belt loading were seen to be relatively unlikely.
44 citations
TL;DR: Acceptable mortality rates compared with the Major Trauma Outcome Study can be achieved in a rural-community-based level I trauma center despite relatively small numbers of critically injured patients, and outcomes may assist in justifying resource allocation for trauma centers in rural areas.
Abstract: Objective: To determine the incidence, severity, and outcomes of injury in patients treated in a rural-based level I trauma center and to compare the outcomes with a nationally indexed patient population—the Major Trauma Outcome Study. Design: Retrospective evaluation of trauma registry data. Setting: State of Illinois designated level I trauma center located in Urbana. Patients: A total of 2246 trauma patients admitted from August 1989 through August 1992, with a mortality cohort of 158 patients. There were 1735 patients (77%) with Injury Severity Scores less than or equal to 19 and 511 patients (23%) with more severe injuries (Injury Severity Scores ≥20). Main Outcome Measures: Mortality rates using the TRISS method, the Major Trauma Outcome Study, and final patient dispositions. Results: The overall mortality rate, excluding those patients who were pronounced dead on arrival, was 125/2213 (5.6%). Eighty-six (69%) of these 125 patients had neurological Abbreviated Injury Scores of 3 or greater, with neurotrauma being a major contributor to their deaths. The m -statistic was 0.99 and the z -statistic was −3.30 for the entire group. The observed probability of survival met or exceeded the expected probability of survival when compared with the Major Trauma Outcome Study in all categories. Conclusion: Acceptable mortality rates compared with the Major Trauma Outcome Study can be achieved in a rural-community—based level I trauma center despite relatively small numbers of critically injured patients. Such outcomes may assist in justifying resource allocation for trauma centers in rural areas. (Arch Surg. 1994;129:800-805)
33 citations
TL;DR: Two hundred ninety-five injury descriptions from 135 consecutive patients treated at a level-I trauma center were coded by three human coders and by TRI-CODE, a PC-based artificial intelligence software program, which had excellent agreement with the correct coding (CC) of AIS severities.
Abstract: Two hundred ninety-five injury descriptions from 135 consecutive patients treated at a level-I trauma center were coded by three human coders (H1, H2, H3) and by TRI-CODE (T), a PC-based artificial intelligence software program. Two study coders are nationally recognized experts who teach AIS coding for its developers (the Association for the Advancement of Automotive Medicine); the third has 5 years experience in ICD and AIS coding. A "correct coding" (CC) was established for the study injury descriptions. Coding results were obtained for each coder relative to the CC. The correct ICD codes were selected in 96% of cases for H2, 92% for H1, 91% for T, and 86% for H3. The three human coders agreed on 222 (75%) injuries. The correct 7 digit AIS codes (six identifying digits and the severity digit) were selected in 93% of cases for H2, 87% for T, 77% for H3, and 73% for H1. The correct AIS severity codes (seventh digit only) were selected in 98.3% of cases for H2, 96.3% for T, 93.9% for H3, and 90.8% for H1. On the basis of the weighted kappa statistic TRI-CODE had excellent agreement with the correct coding (CC) of AIS severities. Each human coder had excellent agreement with CC and with TRI-CODE. Coders H1 and H2 were in excellent agreement. Coder H3 was in good agreement with H1 and H2. However, errors among the human coders often occur for different codes, accentuating the variability.(ABSTRACT TRUNCATED AT 250 WORDS)
27 citations
TL;DR: Road trauma is a major contributor to premature mortality and to morbidity in New Zealand and there were significant differences in the distribution of injury sites by class of road user.
27 citations
TL;DR: The polytrauma patient who sustains a significant head injury (head and neck Abbreviated Injury Scale of 3 or greater) will require prolonged and technically demanding operative intervention for musculoskeletal and associated soft tissue trauma.
Abstract: The polytrauma patient who sustains a significant head injury (head and neck Abbreviated Injury Scale of 3 or greater) will require prolonged and technically demanding operative intervention for musculoskeletal and associated soft tissue trauma. The presence of a head injury may delay the immediate surgical intervention for long bone injuries, which has proven to have major advantages for patient care and well-being. This retrospective review of the Sunnybrook Health Science Centre experience between January 1, 1986, and June 1, 1988, identified 153 polytrauma patients with a significant head injury. Forty-five died from complications unrelated to their long bone injuries or treatment thereof, not surviving long enough to reach the operating room for stabilization of their long bone fractures. The 108 survivors sustained 188 long bone injuries, 63 of which were open fractures. Twenty patients were treated nonoperatively. The 88 patients treated operatively had 12 complications: one peroneal nerve palsy; five cases of sepsis (three in open fractures and all resolving with removal of fixation devices); three malunions; and three cases of delayed union. Sixty-nine patients (78%) were available for long-term follow-up, 64 (93%) making a full recovery. Seven required additional surgery to achieve this goal and another patient awaits an ankle arthrodesis. Examining the head and neck AIS and Injury Severity Score of this group showed that 50 (46%) of these patients were expected to die and 22 (44%) made a full recovery.(ABSTRACT TRUNCATED AT 250 WORDS)
26 citations
TL;DR: Kaiser patients admitted to the Trauma Center at San Francisco General Hospital were studied to determine variables predicting transfer from SFGH to a Kaiser Hospital (repatriation), the length of hospital stay (LOS), and the cost of their care.
Abstract: Health care reform will affect the relationship of trauma centers to health maintenance organizations and other managed care plans. We studied Kaiser Permanente Medical Center (Kaiser) members admitted to the Trauma Center at San Francisco General Hospital (SFGH) to determine : (1) variables predicting transfer from SFGH to a Kaiser Hospital (repatriation), (2) the length of hospital stay (LOS), and (3) the cost of their care. The SFGH trauma registry provided data on 7,794 patients admitted before 1994. To investigate LOS, 89 Kaiser patients over 1 year were matched with non-Kaiser patients on age, maximum Abbreviated Injury Scale score (MAIS) by body region, Injury Severity Score (ISS), head injury severity, and blunt or penetrating injury and disposition. Kaiser patients were significantly younger, more likely to have blunt injury, and had a lower death rate. Significant predictors of repatriation were an MAIS score ≥3, abdominal or extremity injury, and an ISS score of 26 to 40. The mean LOS for all Kaiser patients was 7.6 days, compared with 4.8 for controls (p = 0.20). However, mean LOS was significantly longer in repatriated Kaiser patients compared with controls (16 vs. 7.8 days, p < 0.0005). Kaiser reimbursement rates were comparable with commercial payors, but higher than others. A relatively small number of severely injured patients account for a large percentage of costly trauma care. Analyses of patient subsets are necessary for trauma centers to negotiate suitable relationships with managed care plans. A prospective study is needed to examine the cost efficiency of early transfer of managed care patients.
TL;DR: All unconscious normotensive blunt trauma patients with stable vital signs are suggested to undergo immediate peritoneal lavage to prevent missing life-threatening injuries.
Abstract: The need for simultaneous diagnosis and treatment of life-threatening intracranial mass lesions and intra-abdominal injury results in controversy over the appropriate triage of unconscious blunt trauma patients with stable vital signs. To aid in early decisions for these patients, a retrospective analysis of 290 patients with Glasgow Coma Scale (GCS) scores 90 mm Hg was undertaken. The hypothesis of this study was that life-threatening abdominal injury frequently occurs in these patients and injuries cannot be consistently identified from vital signs alone. Data were analyzed for injury mechanism, SBP, heart rate (HR), Injury Severity Score (ISS), Revised Trauma Score (RTS), Abbreviated Injury Scale score for the abdomen and brain (A-AIS, CNS-AIS), and the need for emergent laparotomy. Patients with concurrent injuries were more likely to come from motor vehicle crashes than falls (p or = 3) were frequently identified based on SBP and HR, the use of clinical signs alone resulted in more missed injuries than did using the results diagnostic peritoneal lavage (DPL). This study suggests that all unconscious normotensive blunt trauma patients undergo immediate DPL to prevent missing life-threatening injuries.
TL;DR: The proposed biomechanical injury cost model utilizes surrogate-based injury assessment functions to predict the probability of occurrence and the probable cost of specific injuries to the head, thorax, abdomen, and lower extremities.
TL;DR: The program ICDTOAIS converts the ICD-9CM coded diagnoses into AIS and ISS scores, enabling the researcher to assess the relative impact of the severity of trauma of different body regions in both morbidity and mortality studies.
Abstract: Diagnoses of injuries as a result of trauma are commonly coded by means of the International Classification of Diseases (9th rev.) Clinical Modification (ICD-9CM). The Abbreviated Injury Scale (AIS) is frequently employed to assess the severity of injury per body region. The Injury Severity Score (ISS) is an over-all index or summary of the severity of injury. To compute one of these two types of scores the entire medical record of each patient must be examined. The program ICDTOAIS replaces the manual coding or translation between the two scores. The program converts the ICD-9CM coded diagnoses into AIS and ISS scores. The program also computes the maximum AIS (MAXAIS) per body region, enabling the researcher to assess the relative impact of the severity of trauma of different body regions in both morbidity and mortality studies. The program locates invalid ICD-9CM rubrics in the data file. ICDTOAIS may be employed as a program alone or as a procedure in database management systems (e.g., DBase III plus, DBase IV, or the different versions of FOXPRO). The program is written in Turbo Pascal, Version 6.
Journal Article•
TL;DR: As expected, patients who did not wear a helmet had a greater AIS average and higher rate of fatality, and forty-one of the 42 fatalities were patients who had been riding on motorcycles without helmets.
01 Jan 1994
TL;DR: The long awaited AAAM Injury Impairment Scale (IIS) has been applied to the UK Co-operative Crash Injury Study field data as mentioned in this paper, and a total of 29,946 injuries, collected over a ten-year period (1983-1992) were re-coded from the Abbreviated Injury Scale (AIS) 85 version to AIS 90 to allow easy allocation of the IIS.
Abstract: The long awaited AAAM Injury Impairment Scale (IIS) has been applied to the UK Co- operative Crash Injury Study field data. A total of 29,946 injuries, collected over a ten year period (1983-1992) were re-coded from the Abbreviated Injury Scale (AIS) 85 version to AIS 90 to allow easy allocation of the IIS. The difficulties associated with re-coding and the compatibility between scales are described. Priorities of injury mitigation based on IIS are compared with those from AIS. The data concerning injured restrained front seat occupants is examined to establish the most frequent cause of both impairing the life-threatening injuries to each body region in different impact configurations. Language: en
01 Jul 1994
TL;DR: A multi-attribute index that maps anatomic descriptions of the nature and extent of injury into scores that reflect the likely extent of functional limitations or reduced capacity at one year post-injury is developed.
Abstract: The objective of this study was to develop a multi-attribute index that maps anatomic descriptions of the nature and extent of injury into scores that reflect the likely extent of functional limitations or reduced capacity at one year post-injury. The development of the Functional Capacity Index (FCI) involved three steps: Development of a comprehensive definition of functional capacity; Assigning relative severity values to the levels within each dimension and to the dimensions themselves; Assigning dimension specific severity levels and whole body scores to the injury descriptions included in the 1990 version of the Abbreviated Injury Scale Dictionary (AIS). The development of FCI will facilitate the use of routinely available information on the nature and extent of injury for classifying injuries according to expected levels of reduced functional capacity.
01 Jan 1994
TL;DR: In this article, a study was carried in order to analyse leg injuries sustained in motorcycle accidents and to find possibilities for improved leg protection, each injury was analyzed with type of injury, localisation and severity Abbreviated Injury Scale (AIS) and correlated to the impact situation with impact direction, impulse angle, load and characteristics of the kinematic behaviour.
Abstract: This study was carried in order to analyse leg injuries sustained in motorcycle accidents and to find possibilities for improved leg protection. Each injury was analyzed with type of injury, localisation and severity Abbreviated Injury Scale (AIS) and correlated to the impact situation with impact direction, impulse angle, load and characteristics of the kinematic behaviour. 258 motorcyclists collided to cars and injured on legs are analyzed in detail. Demands for efficient devices are discussed and accident situations are described in which a special leg protector on the cycle could have the best benefit and what its looks like. (A) For the covering abstract of the conference see IRRD 881069.
Journal Article•
TL;DR: That pedestrians are the least protected participants in traffic is reflected by a considerable fatality rate among pedestrians, which should be useful for designing, implementing, and evaluating a targeted pedestrian safety program in Taiwan.
Abstract: BACKGROUND Pedestrian-vehicle collision is a serious public health problem today in Taiwan, but this issue of pedestrian safety has received relatively little attention. The purpose of this study was to evaluate the characteristics of pedestrian injury after involvement in a collision. METHODS An epidemiologic study on 845 traffic accident consecutive victims, managed at Tri-Service General Hospital in 1990, was performed. They were interviewed with a brief questionnaire about demographic data and types of accident including injured site, Injury Severity Score (ISS) and outcome; the latter was obtained by review of medical records and by a telephone survey performed four months after discharge. RESULTS Results showed a common distribution of injuries for all age groups. Of the 845 patients, 487 were male and 358 were female (sex ratio = 1.4:1). The majority of injuries (84.8%) occurred for pedestrians who were walking on the side of, or crossing, the road. Four hundred and ninety-six victims (58.7%) were treated in the Emergency Department only, while 342 patients (40.5%) were further admitted as inpatients; the remaining 34 patients (4.0%) died in the Emergency Department (0.8%), or as inpatients (3.2%). The study showed fatality rates according to age as follows: 0.5% age 1 to 19, 1.8% age 20 to 39, 4.6% age 40 to 59, 7.5% age 60 or older, with the elderly having the highest pedestrian death rate. Elder pedestrians who were struck by motor vehicles also had the highest fatality rate of all pedestrian injury victims. The percentage of pedestrian injuries is fairly constant from month to month. For time of day, 12 noon and 3 to 5 pm were associated with the most injuries for age 0-19 youths; 4 pm and 10 pm for age 20-59 adults; 8 am and 7 pm for age 60 or older. There was a significant difference of mean ISS between the nonsurvivors (27.8) and the survivors (4.6) (p 60), high Abbreviated Injury Scale (AIS) of head, and high ISS were most common among nonsurvivors (p < 0.01). CONCLUSIONS That pedestrians are the least protected participants in traffic. Situations is reflected by a considerable fatality rate among pedestrians. Data from this study should be useful for designing, implementing, and evaluating a targeted pedestrian safety program in Taiwan.
TL;DR: SHOWICD is an interactive computer program designed to document severity of injury from the ICD-9CM coded injury diagnoses of a particular patient using the Abbreviated Injury Scale and the Injury Severity Score.
Abstract: SHOWICD is an interactive computer program designed to document severity of injury from the ICD-9CM coded injury diagnoses of a particular patient. Two severity-of-injury scores [the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS)] are used. By employing the AIS scores, the severity of injury may be assessed per body region. The ISS provides an over-all index or summary score for severity of injury of the whole body. SHOWICD allows the user to analyze the effects of different types of injuries on the Injury Severity Score. SHOWICD may be employed either alone as a program or as a procedure in database management systems. The program is written in Turbo Pascal.