利用大型基于人群的数据集评估 1998 年至 2008 年简略损伤量表图的效果和局限性。
Assessment of the effects and limitations of the 1998 to 2008 Abbreviated Injury Scale map using a large population-based dataset.
机构信息
Trauma Service, The Royal Children's Hospital Melbourne, Flemington Rd, Parkville 3052, Australia.
出版信息
Scand J Trauma Resusc Emerg Med. 2011 Jan 7;19(1):1. doi: 10.1186/1757-7241-19-1.
BACKGROUND
Trauma systems should consistently monitor a given trauma population over a period of time. The Abbreviated Injury Scale (AIS) and derived scores such as the Injury Severity Score (ISS) are commonly used to quantify injury severities in trauma registries. To reflect contemporary trauma management and treatment, the most recent version of the AIS (AIS08) contains many codes which differ in severity from their equivalents in the earlier 1998 version (AIS98). Consequently, the adoption of AIS08 may impede comparisons between data coded using different AIS versions. It may also affect the number of patients classified as major trauma.
METHODS
The entire AIS98-coded injury dataset of a large population based trauma registry was retrieved and mapped to AIS08 using the currently available AIS98-AIS08 dictionary map. The percentage of codes which had increased or decreased in severity, or could not be mapped, was examined in conjunction with the effect of these changes to the calculated ISS. The potential for free text information accompanying AIS coding to improve the quality of AIS mapping was explored.
RESULTS
A total of 128280 AIS98-coded injuries were evaluated in 32134 patients, 15471 patients of whom were classified as major trauma. Although only 4.5% of dictionary codes decreased in severity from AIS98 to AIS08, this represented almost 13% of injuries in the registry. In 4.9% of patients, no injuries could be mapped. ISS was potentially unreliable in one-third of patients, as they had at least one AIS98 code which could not be mapped. Using AIS08, the number of patients classified as major trauma decreased by between 17.3% and 30.3%. Evaluation of free text descriptions for some injuries demonstrated the potential to improve mapping between AIS versions.
CONCLUSIONS
Converting AIS98-coded data to AIS08 results in a significant decrease in the number of patients classified as major trauma. Many AIS98 codes are missing from the existing AIS map, and across a trauma population the AIS08 dataset estimates which it produces are of insufficient quality to be used in practice. However, it may be possible to improve AIS98 to AIS08 mapping to the point where it is useful to established registries.
背景
创伤系统应在一段时间内持续监测特定的创伤人群。损伤严重度评分（ISS）是一种常用的方法，用于量化创伤登记处的损伤严重程度。为了反映当代创伤管理和治疗，最新版本的损伤严重度评分（AIS08）包含了许多与 1998 年版本（AIS98）相比严重程度不同的代码。因此，采用 AIS08 可能会阻碍使用不同 AIS 版本编码的数据之间的比较。它还可能影响被归类为严重创伤的患者数量。
方法
检索了一个大型基于人群的创伤登记处的完整 AIS98 编码损伤数据集，并使用当前可用的 AIS98-AIS08 字典映射将其映射到 AIS08。研究了严重程度增加或减少或无法映射的代码百分比，以及这些变化对计算得出的 ISS 的影响。还探讨了伴随 AIS 编码的自由文本信息提高 AIS 映射质量的潜力。
结果
共评估了 32134 名患者的 128280 个 AIS98 编码损伤，其中 15471 名患者被归类为严重创伤。尽管从 AIS98 到 AIS08，字典代码的严重程度只有 4.5%下降，但这代表了登记处中近 13%的损伤。在 4.9%的患者中，无法映射任何损伤。由于至少有一个 AIS98 代码无法映射，ISS 在三分之一的患者中可能不可靠。使用 AIS08，被归类为严重创伤的患者数量减少了 17.3%至 30.3%。对一些损伤的自由文本描述进行评估表明，有可能改善 AIS 版本之间的映射。
结论
将 AIS98 编码数据转换为 AIS08 会导致被归类为严重创伤的患者数量显著减少。现有的 AIS 映射中缺少许多 AIS98 代码，在整个创伤人群中，AIS08 数据集的估计质量不足以在实践中使用。然而，有可能改善 AIS98 到 AIS08 的映射，使其对已建立的登记处有用。
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