Injury Severity additional thoughts Lois A Fingerhut NCHS

Injury Severity… additional thoughts… Lois A Fingerhut, NCHS Ellen Mac. Kenzie, Johns Hopkins University National Center for Health Statistics

Challenges in Measuring Injury Severity from ICD codes Currently most “popular”: • ICD-9 CM to AIS via ICDMAP • ICD-9 CM based • AIS and ICDMAP are proprietary • Need AIS for Functional Capacity Index

Challenges in Measuring Injury Severity from ICD codes Emerging interest in: • ICISS • ICD-based injury severity scale • Not yet widely tested • Useful for large administrative data bases

ICISS • Essentially involves calculations of Survival Risk Ratios for each injury • ICISS score is product of SRR’s for each injury • Results are encouraging

Goal: make injury severity scoring easily accessible to all potential users • ICISS offers an alternative to AIS/ICDMAP that needs further validation at the international level • Australia and New Zealand have already done this • Some US trauma based data bases have used ICISS

National level issues • Population vs trauma system based data • Level of specificity of diagnoses varies with system • Mortality codes- less detail (may not work with AIS) • Morbidity • Hospital, ED, household-based • Varying levels of detail and severity • Need for a measure that discriminates at lower levels of severity

Next steps • • ICE project? • US may convene a small consensus meeting among current users Should international scores be pooled for comparability? • Australia, New Zealand • US Trauma-based physicians