Life hazard ratio – a new scale for assessing the severity of injury in the populetionalstud
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The heterogeneous population of patients affected by trauma is extremely difficult to systematize. This is due to the diversity of mechanisms of injury, the nature and severity of the injury and the population, which relate to injuries, diverse in terms of gender, age, presence of comorbidities that make up the final severity of the injury and a certain degree of danger to life.The aim of the study was to develop a universal method to assess the severity of injury and loss of life resulting from their consequences, using the parameters available in the Polish administrative databases, a similar diagnostic efficacy as other used scales to assess the severity of damage.Material and methods. The study analyzed a group of 92 463 patients hospitalized due to injuries sustained as a result of injuries in all hospitals of the Lublin region in 2003-2005. Developed catalogs risk factors, reference to the population of the Lublin province.Results. Developed five models predictive of injury severity scale counterparts, which include different combinations of risk factors associated with the type of injury, age of the patient and the mechanism of injury that have been evaluated for their diagnostic efficacy in differentiating the expected outcomes. Prediction model have the best diagnostic efficacy AUROC 0.9615, SE 0.0025 and 95% CI 0,9565-0,9665, hereinafter referred to as Life Hazard Ratio (LHR), which has a similarly high diagnostic efficacy as the other, examined in the work of the rock assess the severity of damage AUROC 0.9585, SE 0.0368, 95% CI0 0.8849-1.Conclusions. 1. The proposed method of use of the International Classification ICD-10 allows the use of regional administrative databases to conduct detailed analyzes of population and monitor trends in the epidemiology of injuries. 2. Developed Life Hazard Ratio (LHR)is a universal method for the objective evaluation of the severity of injuries and the associated risk of life-threatening, can also conduct population studies. 3. LHR has a comparable rate of diagnostic efficacy as other commonly used scales assessing the severity of the injury.
1 - 07 - 2013
13 - 08 - 2013
- 1. Barquist E, Pizzutiello M, Tian L et al.: Effect of trauma system maturation on mortality rates in patients with blunt injuries in the finger lakes region of New York State. J Trauma 2000; 49: 63-70.[Crossref]
- 2. Meyer AA : Death and disability from injury: a global challenge. J Trauma 1998; 44 (1): 1-12.[Crossref][PubMed]
- 3. W ardle TD : Co-morbid factors in trauma patients. Br Med Bull 1999; 55 (4): 744-56.
- 4. Bielecki M: Metody skalowania obrażeń ciała i ich zastosowanie w traumatologii. Pol Przegl Chir 1997; 69 (6): 659-65.
- 5. Cryer C, Langley JD, Stephenson SC: Measure for measure: the quest for valid indicators of nonfatal injury incidence. Public Health 2002; 116: 257-62.
- 6. K im Y, Jung KY : Utility of the International Classification of Diseases Injury Severity Score: Detecting Preventable Deaths and Comparing the Performance of Emergency Medical Centers. JTrauma 2003; 54: 775-80.
- 7. R ivara FP: Injury control: a guide to research and program evaluation. New York, Cambridge University Press, Cambridge 2001.
- 8. Jurkovich GJ, Mock C: Systematic review of trauma system effectiveness based on registry comparisons. J Trauma 1999; 47: S46-S55.[Crossref][PubMed]
- 9. L efering R: Trauma Score Systems for Quality Assesment. Eur J Trauma 2002; 28: 52-63.
- 10. Mock C, Lormand JD, Goosen J et al.: Guidelines for essential trauma care. World Health Organization, Geneva 2004.
- 11. MacKenzie EJ, Sacco WJ, Hoyt D et al.: Validating the Functional Capacity Index as a measure of outcome following blunt multiple trauma. Qual LifeRes 2002; 11 (8): 797-808.
- 12. Gabbe BJ., Cameron PA., Finch CF: Is the revised trauma score still useful? Aus NZ J Surg 2003; 73: 944-48.
- 13. Osler TM, Baker S, Long W: A modification of the Injury Severity Score that both improves accuracy and simplifies scoring. J Trauma 1997; 43: 922-26.[PubMed][Crossref]
- 14. Osler TM, Rogers FB, Badger GJ et al.: A simple mathematical modification of TRISS markedly improves calibration. J Trauma 2002; 53: 630-34.[PubMed][Crossref]
- 15. MacKenzie EJ, Shapiro S, Moody M et al.: The Abbreviated Injury Scale and Injury Severity Score. Levels of inter- and intrarater reliability. Med Care 1985; 23 (6): 823-31.[Crossref]
- 16. Boyd CR, Tolson MA, Copes WS : Evaluating trauma care: the TRISS method-Trauma Score and Injury Severity Score. J Trauma 1987; 27: 370-78.[Crossref][PubMed]
- 17. Sacco WJ, MacKenzie EJ, Champion H et al.: Comparison of alternative methods for assessing injury severity based on anatomic descriptors. JTrauma 1999; 47: 441-46.
- 18. Senkowski C, McKenney M: Trauma scoring systems: a review. J Am Coll Surg 1999; 189: 491-503.
- 19. Garber BG, Herbert PC., Wells G et al.: Validation of trauma and injury severity score in blunt trauma patients by using a Canadian Trauma Registry. J Trauma 1996; 40: 733-77.[Crossref]
- 20. Sampalis JS, Denis R, Lavoie A et al.: Trauma care regionalization: a process-outcome evaluation. J Trauma 1999; 46 (4): 565-79.[Crossref]
- 21. Sthaun CR, Stephenson BS, Langley JD et al.: Comparing measures of injury severity for use with large databases. J Trauma 2002; 53: 326-32.
- 22. Hannan EL , Farrel LS , Gorthy SH et al.: Predictors of mortality in adult patients with blunt injuries in New York State: a comparison of the trauma and injury severity score (TRISS) and the International Classification of Diseases Ninth Revision-based Injury Severity Score (ICISS). JTrauma 1999; 47 (1): 8-14.
- 23. O sler TM, Rutledge R, Deis J et al.: ICISS: an international classification of disease-9 based injury severity score. J Trauma 1996; 41: 380-88.
- 24. Rutledge R, Hoyt D, Eastman AE et al.: Comparison of the injury severity score and ICD-9 diagnosis codes as predictors of outcome in injury: analysis of 44, 032 patients. J Trauma 1997; 42: 477-89.[Crossref]
- 25. O sler TM, Roger FB, Glance LG et al.: Predicting survival, length of stay, and cost in the surgical intensive care unit: APACHE II versus ICISS. JTrauma 1998; 45: 234-38.
- 26. S tephenson S, Henley G, Harrison JE et al.: Diagnosis based injury severity scaling: investigation of a method using Australian and New Zealand hospitalizations. Inj Prev 2004; 10 (6): 379-83.
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