Trauma scores and trauma outcome measures

Abstract

Objective measurement and quantification of injury severity are necessary for triage, performance evaluation and research. In order to evaluate interventions, outcomes must also be compared. While this can be done using hospital stay or mortality, these will fail to detect subtle differences. Impact of injury on health can be quantified using a variety of scoring systems. Trauma scoring and outcome measurement have grown increasingly complex in recent years and are likely to become more so in the future.

Keywords

trauma severity indices treatment outcome multiple trauma outcome and process assessment (health care)

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References

American Association for Automotive Medicine (now American Association for the Advancement of Automotive Medicine) . 1976. The Abbreviated Injury Scale (AIS) 1976 Revision, including dictionary. Des Plaines, Illinois: American Association for Automotive Medicine.

American Association for Automotive Medicine (now American Association for the Advancement of Automotive Medicine) . 1980. The Abbreviated Injury Scale, 1980 Revision. Des Plaines, Illinois: American Association for Automotive Medicine.

American Association for Automotive Medicine (now American Association for the Advancement of Automotive Medicine) . 1985. The Abbreviated Injury Scale, 1985 Revision. Des Plaines, Illinois: American Association for Automotive Medicine.

American Association for the Advancement of Automotive Medicine . 1990. The Abbreviated Injury Scale, 1990 Revision. Des Plaines, Illinois: American Association for the Advancement of Automotive Medicine.

American Association for the Advancement of Automotive Medicine . 1998. The Abbreviated Injury Scale, 1990 Revision (1998 update). Des Plaines, Illinois: American Association for the Advancement of Automotive Medicine.

Asikainen I , Kaste M , Sarna S. 1998. Predicting late outcome for patients with traumatic brain injury referred to a rehabilitation programme: a study of 508 Finnish patients 5 years or more after injury. Brain Inj 12: 95-107.

Bergner M , Bobbitt RA , Pollard WE et al. 1976. The sickness impact profile: validation of a health status measure. Med Care 14(1): 57-67.

Boffard KD. 2002.Trauma scores and scoring systems. In: Boffard KD ed. Definitive surgical trauma care manual. Pratteln, Switzerland: International Society of Surgery, International Association for the Surgery of Trauma and Surgical Intensive Care (IATSIC). Appendix B, B1-B25.

10.

Boyd CR , Tolson MA , Copes WS. 1987. Evaluating trauma care: the TRISS method. Trauma Score and the Injury Severity Score. J Trauma Injury Infect Crit Care 27(4): 370-378.

11.

Brenneman FD , Redelmeier DA , Boulanger BR et al. 1997. Long-term outcomes in blunt trauma: who goes back to work?. J Trauma Injury Infect Crit Care 42(5): 778-781.

12.

Bull JP. 1975. The injury severity score of road traffic casualties in relation to mortality, time of death, hospital treatment time and disability. Accident Anal Prevent 7: 249-255.

13.

Champion HR , Sacco WJ , Carnazzo AJ et al. 1981. Trauma score. Crit Care Med 9(9): 672-676.

14.

Champion HR , Sacco WJ , Copes WS et al. 1989. A revision of the Trauma Score. J Trauma Injury Infect Crit Care 29(5): 623-629.

15.

Champion HR , Copes WS , Sacco WJ et al. 1990. A new characterization of injury severity. J Trauma Injury Infect Crit Care 30(5): 539-545; discussion 545-46.

16.

Champion HR , Copes WS , Sacco WJ et al. 1996. Improved predictions from a severity characterization of trauma (ASCOT) over Trauma and Injury Severity Score (TRISS): results of an independent evaluation.[comment]. J Trauma Injury Infect Crit Care 40(1): 42-48.

17.

Choi SC , Marmarou A , Bullock R et al. 1998. Primary end points in phase III clinical trials of severe head trauma: DRS versus GOS. The American Brain Injury Consortium Study Group. J Neurotrauma 15(10): 771-776.

18.

Cohen IB. 1984. Florence Nightingale. Scientific American 250: 128-137.

19.

Cohen ME , Ditunno JF , Donovan WH et al. 1998. A test of the 1992 international standards for neurological and functional classification of spinal cord injury. Spinal Cord 36: 554-560.

20.

Committee on Medical Aspects of Automotive Safety . 1971. Rating the severity of tissue damage: I. The abbreviated scale. JAMA 215: 277-280.

21.

Committee on Medical Aspects of Automotive Safety . 1972. Rating the severity of tissue damage: I. The abbreviated scale. JAMA 220: 717-720.

22.

Copes WS , Champion HR , Sacco WJ et al. 1988. The Injury Severity Score revisited. J Trauma Injury Infect Crit Care 28(1): 69-77.

23.

Copes WS , Champion HR , Sacco WJ et al. 1990. Progress in characterizing anatomic injury. J Trauma Injury Infect Crit Care 30(10): 1200-2007.

24.

Curt A , Dietz V. 1999. Electrophysiological recordings in patients with spinal cord injuries: significance for predicting outcome. Spinal Cord 37: 554-560.

25.

Dimar JR , Wilde PH , Glassman SD et al. 1996. Thoracolumbar burst fractures treated by anterior and posterior surgery. Am J Orthopaedics 25: 159-165.

26.

Ditunno JF ed. 1992. ASIA Classification. Standards for neurological and functional classification of spinal cord injury. Illinois, Chicago: American Spinal Injuries Association.

27.

Dombi GW , Nandi P , Saxe JM et al. 1995. Prediction of rib fracture injury outcome by an artificial neural network. J Trauma Injury Infect Crit Care 39(5): 915-921.

28.

Dove DB , Stahl, WM , Del Guercio, LRM. 1980. A five-year review of deaths following urban trauma. J Trauma 20: 760-766.

29.

El Masry WS , Tsubo M , Katoh S et al. 1996. Validation of the American Spinal Injury Association (ASIA) motor score and the National Acute Spinal Cord Injury Study (NASCIS) motor score. Spine 21(5): 614-619.

30.

Fern KT , Smith JT , Zee B et al. 1998. Trauma patients with multiple extremity injuries: resource utilization and long-term outcome in relation to injury severity scores. J Trauma Injury Infect Crit Care 45(3): 489-494.

31.

Frankel H , Hancock DO , Hyslop G. 1969. The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Paraplegia 7: 179-192.

32.

Frostick SP , HunterJB . 1993. Complications. In: Carr A. ed. Outcome measures in orthopaedics. Oxford: Butterworth Heinemann.

33.

Gilson B , Gilson J , Bergner M et al. 1975. Sickness Impact Profile: development of a health status measure. Am J Public Health 65: 1304-1310.

34.

Hannan EL , Farrell LS , Gorthy SF et al. 1999. 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 Disease, Ninth Revision-based Injury Severity Score (ICISS). J Trauma Injury Infect Crit Care 47(1): 8-14.

35.

Helfet DL , Howey T , Sanders R et al. 1990. Limb salvage versus amputation. Preliminary results of the Mangled Extremity Severity Score. Clin Orthop Relat Res 256: 80-86.

36.

Hunt S , McEwen J , McKenna S. 1985. Measuring health status: a new tool for clinicians and epidemiologists. J Roy Coll General Practitioners 35: 185-188.

37.

Hunter A , Kennedy L , Henry J et al. 2000. Application of neural networks and sensitivity analysis to improved prediction of trauma survival. Comput Methods Programs Biomed 62(1): 11-19.

38.

Izenberg SD , Williams MD , Luterman A. 1997. Prediction of trauma mortality using a neural network. Am Surgeon 63(3): 275-281.

39.

Jennett B , Bond M. 1975. Assessment of outcome after severe brain damage. Lancet (I): 480-484.

40.

Jennett B , Snoek J , Bond MR et al. 1981. Disability after severe head injury: observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry 44(4): 285-293.

41.

Johansen K , Daines M , Howey T et al. 1990. Objective criteria accurately predict amputation following lower extremity trauma. J Trauma Injury Infect Crit Care 30(5): 568-572; discussion 572-73.

42.

Katoh S , El Masry WS , Jaffray D et al. 1996. Neurologic outcome in conservatively treated patients with incomplete closed traumatic cervical spinal cord injuries. Spine 21: 2345-2351.

43.

Kim NH , Lee HM , Chun IM. 1999. Neurologic injury in patients with burst fracture of the thoracolumbar spine. Spine 24: 290-293.

44.

Kingma J , Ten Vergert E , Werkman HA et al. 1994. A Turbo Pascal program to convert ICD-9CM coded injury diagnoses into injury severity scores: ICDTOAIS. Perceptual Motor Skills 78(3 Pt 1): 915-936.

45.

Knopp R , Yanagi A , Kallsen G. 1987. Mechanism of injury and anatomic injury as criteria for prehospital trauma triage. Ann Emerg Med 17: 55-55.

46.

Lai YC , Chen FG , Goh MH et al. 1998. Predictors of long term outcome on severe head injury. Ann Acad Med Singapore 27: 326-331.

47.

Maas AIR , Braakman R , Schoutin HJA et al. 1983. Agreement between physicians on assessment of outcome following severe head injury. J Neurosurg 58: 321-325.

48.

MacKenzie EJ , Steinwachs DM , Shankar BS. 1989. Classifying severity of trauma based on hospital discharge diagnoses: validation of an ICD-9CM to AIS-85 conversion table. Med Care 27: 412-422.

49.

Marble RP , Healy JC. 1999. A neural network approach to the diagnosis of morbidity outcomes in trauma care. Artif Intell Med 15(3): 299-307.

50.

Markle J , Cayten CG , Byrne DW et al. 1992. Comparison between TRISS and ASCOT methods in controlling for injury severity. J Trauma Injury Infect Crit Care 33(2): 326-332.

51.

Massagli TL , Michaud LJ , Rivara FP. 1996. Association between injury indices and outcome after severe traumatic brain injury in children. Arch Phys Med Rehabil 77(2): 125-132.

52.

Moore EE , Shackford SR , Pachter HL et al. 1989. Organ injury scaling: spleen, liver, and kidney. J Trauma Injury Infect Crit Care 29(12): 1664-1666.

53.

Moore EE , Cogbill TH , Malangoni MA et al. 1990. Organ injury scaling, II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma Injury Infect Crit Care 30(11): 1427-1429.

54.

Moore EE , Cogbill TH , Jurkovich GJ et al. 1992. Organ injury scaling. III: chest wall, abdominal vascular, ureter, bladder, and urethra. J Trauma Injury Infect Crit Care 33(3): 337-339.

55.

Moore EE , Malangoni MA , Cogbill TH et al. 1994. Organ injury scaling. IV: thoracic vascular, lung, cardiac, and diaphragm. J Trauma Injury Infect Crit Care 36(3): 299-300.

56.

Moore EE , Cogbill TH , Jurkovich GJ et al. 1995a. Organ injury scaling: spleen and liver (1994 revision). J Trauma Injury Infect Crit Care 38(3): 323-324.

57.

Moore EE , Cogbill TH , Malangoni MA et al. 1995b. Organ injury scaling. Surg Clin N Am 75(2): 293-303.

58.

Moore EE , Jurkovich GJ , Knudson MM et al. 1995c. Organ injury scaling. VI: extrahepatic biliary, esophagus, stomach, vulva, vagina, uterus (nonpregnant), uterus (pregnant), fallopian tube, and ovary. J Trauma Injury Infect Crit Care 39(6): 1069-1070.

59.

Norwood SH , McAuley CE , Berne JD et al. 2000. A prehopsital Glasgow Coma Scale Score < = 14 accurately predicts the need for full trauma team activation and patient hospitalisation after motor vehicle collisions. J Trauma 53(3): 503-507.

60.

Rappaport M , Hall KM , Hopkins HK et al. 1982. Disability rating scale for severe head trauma: coma to community. Arch Phys Med Rehabil 63: 118-123.

61.

Rutledge R , Fakhry S , Baker C et al. 1993. Injury severity grading in trauma patients: a simplified technique based upon ICD-9 coding. J Trauma Injury Infect Crit Care 35(4): 497-506; discussion 506-507.

62.

Rutledge R. 1995. Injury severity and probability of survival assessment in trauma patients using a predictive hierarchical network model derived from ICD-9 codes. J Trauma Injury Infect Crit Care 38(4): 590-597; discussion 597-601.

63.

Rutledge R , Osler T , Kromhout-Schiro S. 1998a. Illness severity adjustment for outcomes analysis: validation of the ICISS methodology in all 821,455 patients hospitalized in North Carolina in 1996. Surgery 124(2): 187-194; discussion 194-96.

64.

Rutledge R , Osler T , Emery S et al. 1998b. The end of the Injury Severity Score (ISS) and the Trauma and Injury Severity Score (TRISS): ICISS, an International Classification of Diseases, ninth revision-based prediction tool, outperforms both ISS and TRISS as predictors of trauma patient survival, hospital charges, and hospital length of stay. J Trauma Injury Infect Crit Care 44(1): 41-49.

65.

Swiontkowski MF. 1996. The multiply injured patient with musculoskeletal injuries. In: Rockwood C et al. eds. Rockwood and Green’s fractures in adults. Philadelphia: Lippincott-Raven,150-151.

66.

Teasdale G , Jennett B. 1974. Assessment of coma and impaired consciousness. A practical scale. Lancet 2(7872): 81-84.

67.

Tepas JJ 3rd , Ramenofsky ML , Mollitt DL et al. 1988. The Pediatric Trauma Score as a predictor of injury severity: an objective assessment. J Trauma Injury Infect Crit Care 28(4): 425-429.

68.

Toh E , Arima T , Mochid AJ et al. 1998. Functional evaluation using motor scores after cervical spinal cord injuries. Spinal Cord 36: 491-496.

69.

Turchin DC , Schemitsch EH , McKee MD et al. 1999. Do foot injuries significantly affect the functional outcome of multiply injured patients?. J Orthopaed Trauma 13(1): 1-4.

70.

Westgren N , Levi R. 1998. Quality of life and traumatic spinal cord injury. Arch Phys Med Rehabil 79(11): 1433-1439.

71.

Williams A. 1991. Setting priorities in healthcare: an economists view. J Bone Joint Surg 73: 365-367.