Injury Severity… additional thoughts…

1. Injury Severity…additional thoughts… Lois A Fingerhut, NCHS Ellen MacKenzie, Johns Hopkins University

2. Challenges in Measuring Injury Severity from ICD codes Currently most “popular”: • ICD-9 CM to AIS via ICDMAP • ICD-9 CM based • AIS and ICDMAP are proprietary • Need AIS for Functional Capacity Index

3. Challenges in Measuring Injury Severity from ICD codes Emerging interest in: • ICISS • ICD-based injury severity scale • Not yet widely tested • Useful for large administrative data bases

4. ICISS • Essentially involves calculations of Survival Risk Ratios for each injury • ICISS score is product of SRR’s for each injury • Results are encouraging

5. Goal: make injury severity scoring easily accessible to all potential users • ICISS offers an alternative to AIS/ICDMAP that needs further validation at the international level • Australia and New Zealand have already done this • Some US trauma based data bases have used ICISS

6. National level issues • Population vs trauma system based data • Level of specificity of diagnoses varies with system • Mortality codes- less detail (may not work with AIS) • Morbidity • Hospital, ED, household-based • Varying levels of detail and severity • Need for a measure that discriminates at lower levels of severity

7. Next steps • ICE project? • Should international scores be pooled for comparability? • US may convene a small consensus meeting among current users • Australia, New Zealand • US Trauma-based physicians