Trauma Service, The Royal Children's Hospital Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Injury. 2013 Nov;44(11):1437-42. doi: 10.1016/j.injury.2012.08.033. Epub 2012 Sep 14.
Many trauma registries have used the 1990 revision of the Abbreviated Injury Scale (AIS; AIS90) to code injuries sustained by trauma patients. Due to changes made to the AIS codeset since its release, AIS90-coded data lacks currency in the assessment of injury severity. The ability to map between the 1998 revision of AIS (AIS98) and the current (2008) AIS version (AIS08) already exists. The development of a map for transforming AIS90-coded data into AIS98 would therefore enable contemporary injury severity estimates to be derived from AIS90-coded data.
Differences between the AIS90 and AIS98 codesets were identified, and AIS98 maps were generated for AIS90 codes which changed or were not present in AIS98. The effectiveness of this map in describing the severity of trauma using AIS90 and AIS98 was evaluated using a large state registry dataset, which coded injury data using AIS90 over several years. Changes in Injury Severity Scores (ISS) calculated using AIS90 and mapped AIS98 codesets were assessed using three distinct methods.
Forty-nine codes (out of 1312) from the AIS90 codeset changed or were not present in AIS98. Twenty-four codes required the assignment of maps to AIS98 equivalents. AIS90-coded data from 78,075 trauma cases were used to evaluate the map. Agreement in calculated ISS between coded AIS90 data and mapped AIS98 data was very high (kappa=0.971). The ISS changed in 1902 cases (2.4%), and the mean difference in ISS across all cases was 0.006 points. The number of cases classified as major trauma using AIS98 decreased by 0.8% compared with AIS90. A total of 3102 cases (4.0%) sustained at least one AIS90 injury which required mapping to AIS98.
This study identified the differences between the AIS90 and AIS98 codesets, and generated maps for the conversion process. In practice, the differences between AIS90- and AIS98-coded data were very small. As a result, AIS90-coded data can be mapped to the current AIS version (AIS08) via AIS98, with little apparent impact on the functional accuracy of the mapped dataset produced.
许多创伤登记处使用 1990 年修订的简明损伤定级标准（AIS；AIS90）对创伤患者的损伤进行编码。由于自发布以来 AIS 编码集发生了变化，因此 AIS90 编码数据在评估损伤严重程度方面已经过时。AIS98 与当前（2008 年）AIS 版本（AIS08）之间的映射能力已经存在。因此，开发一种将 AIS90 编码数据转换为 AIS98 的映射将使能够从 AIS90 编码数据中得出当代损伤严重程度的估计值。
确定了 AIS90 和 AIS98 编码集之间的差异，并为 AIS90 代码生成了 AIS98 映射，这些代码在 AIS98 中发生了变化或不存在。使用大型州登记数据集评估了该映射在使用 AIS90 和 AIS98 描述创伤严重程度方面的有效性，该数据集在几年内使用 AIS90 对损伤数据进行了编码。使用三种不同的方法评估使用 AIS90 和映射 AIS98 编码集计算得出的伤害严重程度评分（ISS）的变化。
AIS90 编码集中有 49 个代码（占 1312 个）发生了变化或不存在于 AIS98 中。有 24 个代码需要分配 AIS98 等效代码。使用来自 78075 例创伤病例的 AIS90 编码数据来评估该映射。编码 AIS90 数据与映射 AIS98 数据之间计算得出的 ISS 非常吻合（kappa=0.971）。ISS 在 1902 例病例中发生变化（2.4%），所有病例中 ISS 的平均差异为 0.006 分。使用 AIS98 分类为重大创伤的病例数比 AIS90 减少了 0.8%。共有 3102 例（4.0%）至少有一处需要映射到 AIS98 的 AIS90 损伤。
本研究确定了 AIS90 和 AIS98 编码集之间的差异，并为转换过程生成了映射。实际上，AIS90 和 AIS98 编码数据之间的差异非常小。因此，AIS90 编码数据可以通过 AIS98 映射到当前的 AIS 版本（AIS08），对生成的映射数据集的功能准确性几乎没有明显影响。
