MacKenzie E J, Damiano A, Miller T, Luchter S
Center for Injury Research and Policy, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
J Trauma. 1996 Nov;41(5):799-807. doi: 10.1097/00005373-199611000-00006.
This paper describes the development of the Functional Capacity Index (FCI) and compares it to the Abbreviated Injury Scale (AIS) and the Injury Impairment Scale (IIS).
The FCI maps 1990 AIS injury descriptions into scores that reflect expected levels of reduced functional capacity at 1 year after injury. Its development involved three steps. First, an expert clinical panel identified 10 relevant dimensions of function and defined levels of capacity within each dimension. A group of 114 individuals then rated the relative severity of different levels of function in terms of their impact on daily living. The third step involved clinical experts assigning FCI scores to AIS '90 injury descriptions based on their knowledge of the likely 1-year consequences associated with each injury. As a first step in validating the FCI, 1 year postinjury levels of impairment (based on range of motion and strength) were correlated with FCI, IIS, and AIS scores derived for 301 patients with severe lower extremity fractures.
Consistency of FCI scores derived within and across dimensions of function argue for the conceptual integrity of the index. Non-zero FCI scores were assigned to only 26% of the 1,272 AIS injury descriptions, indicating that, for most of the injuries in the AIS dictionary, very little or no residual impairment is expected for the average person at 1 year. FCI scores derived for 301 patients with lower extremity fractures ranged from 0 to 63 (out of a possible 100 points). A modest correlation was found between FCI scores and actual levels of impairment observed at 1 year. Compared with the AIS and the IIS, the FCI appeared to discriminate somewhat better among different levels of function.
Although further empirical validation of the FCI is essential before it can be broadly applied, its development represents an important first step in the generation of an AIS-based measure of expected functional outcome. Its validation is encouraged across a variety of settings and injury types.
本文描述了功能能力指数（FCI）的开发过程，并将其与简明损伤定级标准（AIS）和损伤伤残评定量表（IIS）进行比较。
FCI将1990年AIS损伤描述映射为反映损伤后1年预期功能能力降低水平的分数。其开发涉及三个步骤。首先，一个专家临床小组确定了10个相关功能维度，并定义了每个维度内的能力水平。然后，一组114人根据不同功能水平对日常生活的影响对其相对严重程度进行了评分。第三步是临床专家根据他们对每种损伤可能的1年后果的了解，为AIS '90损伤描述分配FCI分数。作为验证FCI的第一步，对301例严重下肢骨折患者损伤后1年的伤残水平（基于活动范围和力量）与FCI、IIS和AIS分数进行了相关性分析。
功能维度内和维度间得出的FCI分数的一致性证明了该指数的概念完整性。在1272个AIS损伤描述中，只有26%被赋予了非零FCI分数，这表明，对于AIS词典中的大多数损伤，预计普通人在1年后几乎没有或没有残留损伤。301例下肢骨折患者的FCI分数在0至63分之间（满分100分）。发现FCI分数与1年时观察到的实际损伤水平之间存在适度相关性。与AIS和IIS相比，FCI在不同功能水平之间的区分度似乎略好。
尽管在FCI能够广泛应用之前，进一步的实证验证至关重要，但其开发是基于AIS生成预期功能结果测量方法的重要第一步。鼓励在各种环境和损伤类型中对其进行验证。
