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Issues to consider when estimating injury severity during risk assessment

Issues to consider when estimating injury severity during risk assessment. Dr Kirsten Vallmuur and Ms Jesani Limbong 11 th October 2013. CRICOS No. 00213J. Focus of presentation. Core input into risk assessment model is the injury severity rank and probability of occurrence

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Issues to consider when estimating injury severity during risk assessment

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  1. Issues to consider when estimating injury severity during risk assessment Dr Kirsten Vallmuur and MsJesaniLimbong 11th October 2013 CRICOS No. 00213J

  2. Focus of presentation • Core input into risk assessment model is the injury severity rank and probability of occurrence • Injury severity rank = Table of injury types and body regions grouped into 4 or 6 point scale • Core questions: • How valid is the grouping of injuries? • How consistent are these groupings across different severity scales? • How concordant are these groupings with other indicators of injury severity?

  3. Injury severity ranking systems Canada (Health Canada) New Zealand Europe/Australia (RAPEX Guidelines)

  4. Comparison of RAPEX and Canadian Injury Severity Categorisation

  5. Implications of Different Severity Categorisation • Injuries falling below the threshold may not be raised to an investigation level in one jurisdiction but may be in another -> inconsistent risk prioritisation • If injuries where differences exist are very common, may lead to considerable discrepancy (i.e. severity of different fractures) • Explore injury data to get an indication of size of problem and decide if better uniformity needed

  6. Classifying injury data into severity categories • Injury severity ranks are largely based on injury nature and body region • Hospitalisation and mortality data have injury diagnoses coded (codes structured into nature of injury and body region codes) • Assigning severity scores to injury data allows for better illustration of severity by hazard and product

  7. Burns Severity Rank Comparisons

  8. Example categorisation of burns data in Queensland children

  9. Validating injury severity ranks • Other health system-based injury severity scales: • ICD-based Injury Severity Score (ICISS) => survival risk ratio (SRR) • Abbreviated injury score (AIS) • Other indicators of severity: • Triage urgency • Emergency department presentation/ hospital admission/mortality rates • Length of stay • Costs of treatment • Disability outcomes

  10. Next steps • Compare injury data for the injuries where ranks differ across injury severity systems • Evaluate the validity of the ranks by comparison with other health system-based injury severity scales and with other severity indicators • Revise and consolidate different injury severity scales to establish a single international scale for categorisation of injury severity

  11. Questions? k.vallmuur@qut.edu.au Reports: http://eprints.qut.edu.au/46518/ http://eprints.qut.edu.au/58389/ CRICOS No. 00213J

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