Tohira Hideo, Jacobs Ian, Mountain David, Gibson Nick, Yeo Allen, Ueno Masato, Watanabe Hiroaki
School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Western Australia, Australia.
J Trauma. 2011 Dec;71(6):1829-34. doi: 10.1097/TA.0b013e31823cc5c5.
The Abbreviated Injury Scale 2008 (AIS 2008) is the most recent injury coding system. A mapping table from a previous AIS 98 to AIS 2008 is available. However, AIS 98 codes that are unmappable to AIS 2008 codes exist in this table. Furthermore, some AIS 98 codes can be mapped to multiple candidate AIS 2008 codes with different severities. We aimed to modify the original table to adjust the severities and to validate these changes.
We modified the original table by adding links from unmappable AIS 98 codes to AIS 2008 codes. We applied the original table and our modified table to AIS 98 codes for major trauma patients. We also assigned candidate codes with different severities the weighted averages of their severities as an adjusted severity. The proportion of cases whose injury severity scores (ISSs) were computable were compared. We also compared the agreement of the ISS and New ISS (NISS) between manually determined AIS 2008 codes (MAN) and mapped codes by using our table (MAP) with unadjusted or adjusted severities.
All and 72.3% of cases had their ISSs computed by our modified table and the original table, respectively. The agreement between MAN and MAP with respect to the ISS and NISS was substantial (intraclass correlation coefficient = 0.939 for ISS and 0.943 for NISS). Using adjusted severities, the agreements of the ISS and NISS improved to 0.953 (p = 0.11) and 0.963 (p = 0.007), respectively.
Our modified mapping table seems to allow more ISSs to be computed than the original table. Severity scores exhibited substantial agreement between MAN and MAP. The use of adjusted severities improved these agreements further.
《2008年简明损伤定级标准》（AIS 2008）是最新的损伤编码系统。有一个从先前的AIS 98到AIS 2008的映射表。然而，该表中存在无法映射到AIS 2008编码的AIS 98编码。此外，一些AIS 98编码可映射到多个严重程度不同的候选AIS 2008编码。我们旨在修改原始表格以调整严重程度并验证这些更改。
我们通过添加从无法映射的AIS 98编码到AIS 2008编码的链接来修改原始表格。我们将原始表格和修改后的表格应用于重大创伤患者的AIS 98编码。我们还为不同严重程度的候选编码赋予其严重程度的加权平均值作为调整后的严重程度。比较了损伤严重程度评分（ISS）可计算的病例比例。我们还比较了手动确定的AIS 2008编码（MAN）与使用我们的表格（MAP）映射的编码在未调整或调整严重程度情况下的ISS和新ISS（NISS）的一致性。
分别有100%和72.3%的病例通过我们修改后的表格和原始表格计算出了ISS。MAN和MAP在ISS和NISS方面的一致性很强（组内相关系数：ISS为0.939，NISS为0.943）。使用调整后的严重程度，ISS和NISS的一致性分别提高到了0.953（p = 0.11）和0.963（p = 0.007）。
我们修改后的映射表似乎比原始表格能计算出更多的ISS。严重程度评分在MAN和MAP之间表现出很强的一致性。使用调整后的严重程度进一步提高了这些一致性。
