Rutledge R, Fakhry S, Baker C, Oller D
North Carolina Trauma Registry, North Carolina Memorial Hospital, Wake Medical Center/Area Health Education Center, Chapel Hill.
J Trauma. 1993 Oct;35(4):497-506; discussion 506-7.
The purpose of this study was to develop a simplified method of stratifying patient risk of death based on ICD-9 codes.
Data were obtained from a statewide trauma registry. A mortality risk ratio (MRR) was derived from a "training" subset by calculating a mortality rate for each ICD-9 code of interest. The independent variables of interest included TS, ISS, and MRRs (for the 1st & 2nd Dx, 1st op, & E code).
(n = 37,100). When the 1st Dx and ISS were used as candidate variables in stepwise multivariate modeling, the MRR for the 1st Dx was the first variable to be entered into the model (1st Dx partial R2 = 0.37, ISS partial R2 = 0.02).
This study shows that the 1st Dx is a better predictor of outcome than ISS. Since ICD-9 codes are more easily obtained and are better predictors of outcome, this study suggests that they may supersede the use of the ISS in injury severity scoring.
本研究的目的是开发一种基于ICD - 9编码对患者死亡风险进行分层的简化方法。
数据取自全州范围的创伤登记处。通过计算每个感兴趣的ICD - 9编码的死亡率，从一个“训练”子集中得出死亡率风险比（MRR）。感兴趣的自变量包括创伤评分（TS）、损伤严重度评分（ISS）以及MRR（用于首次诊断和第二次诊断、首次手术及E编码）。
（n = 37100）。在逐步多变量建模中，当将首次诊断和ISS用作候选变量时，首次诊断的MRR是第一个进入模型的变量（首次诊断的偏R² = 0.37，ISS的偏R² = 0.02）。
本研究表明，首次诊断比ISS更能预测预后。由于ICD - 9编码更容易获取且对预后的预测性更好，本研究提示它们可能会取代ISS在损伤严重度评分中的应用。
