Injury impairment and disability scales to assess the permanent consequences of trauma.

Impairment and disability caused by injury are major public health costs in terms of monetary losses and personal suffering. Currently, there is no satisfactory method of measuring these losses. Impairment is the loss of function after injury healing. The level of impairment depends on the type and severity of injury in conjunction with medical-social factors. An Injury Impairment Scale (IIS) similar to the Abbreviated Injury Scale (AIS) is proposed, with severity codes of 0-6 like the AIS. The criteria of Mobility/Dexterity, Cognitive/Psychological, Cosmetic/Disfigurement, Sensory, Pain, and Sexual/Reproduction are used for coding impairment resulting from injury. Methods for determining whole body impairment (WBI) are discussed. Use of the highest impairment code on any criterion is suggested at this time to assign WBI. Disability depends on a patient's impairment and ability to accommodate the impairment. Factors such as education, past employment, family and community support, and personal and community resources play a role in the patient's ability to accommodate an impairment, fulfill the activities of daily living, socialize, and be productively employed. An Injury Disability Scale (IDS) and method of determining disability from impairment is proposed. Three patient case studies utilizing the proposed coding systems are presented. Validation of the injury impairment and disability scales will require in-depth evaluation by several institutes and medical facilities with large databases that include adequate follow-up examination information. This paper addresses the concepts for injury, impairment, and disability scaling and establishes a framework to undertake injury control research.