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Same Abbreviated Injury Scale Values May Be Associated with Different Risks to Mortality in Trauma Patients: A Cross-Sectional Retrospective Study Based on the Trauma Registry System in a Level I Trauma Center

Author

Listed:
  • Cheng-Shyuan Rau

    (Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 88301, Taiwan
    These authors contributed equally to this work.)

  • Shao-Chun Wu

    (Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 88301, Taiwan
    These authors contributed equally to this work.)

  • Pao-Jen Kuo

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 88301, Taiwan)

  • Yi-Chun Chen

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 88301, Taiwan)

  • Peng-Chen Chien

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 88301, Taiwan)

  • Hsiao-Yun Hsieh

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 88301, Taiwan)

  • Ching-Hua Hsieh

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 88301, Taiwan)

Abstract

The Abbreviated Injury Scale (AIS) measures injury severity of a trauma patient with a numeric method for ranking anatomy-based specific injuries. The summation of the squares of the three most severe injuries in the AIS of six predefined body regions comprises the Injury Severity Score (ISS). It assumes that the mortality of a given AIS value is similar across all body regions. However, such an assumption is less explored in the literature. In this study, we aimed to compare the mortality rates of the patients with the same AIS value in different injured body regions in a level I trauma center. Hospitalized adult trauma patients with isolated serious to critical injury (AIS of 3 to 5) between 1 January 2009, and 31 December 2016, from the Trauma Registry System in a level I trauma center were grouped according to the injured body regions (including, the head/neck, thorax, abdomen, or extremities) and were exclusively compared according to their AIS stratum. Categorical data were compared using the two-sided Fisher exact or Pearson chi-square tests. ANOVA with Games-Howell post hoc test was performed to assess the differences in continuous data of the patients with injury in different body regions. The primary outcome of the study was in-hospital mortality. The adjusted odds ratios (AORs) were estimated using a stepwise selection of a multivariable regression model adjusted by controlling the confounding variables such as sex, age, comorbidities, and ISS. Survival curves were estimated with the Kaplan–Meier approach with a corresponding log-rank test. The patients with AIS of 5 for abdomen injury and those with AIS of 3 for extremity injury had a significantly lower odds of adjusted mortality (adjusted odds ratio (AOR) 0.1, 95% confidence interval (CI) 0.01–0.39, p = 0.004 and AOR 0.3, 95% CI 0.15–0.51, p < 0.001, respectively) than that of the patients with head/neck injury. However, the patients with AIS of 4 for extremity injury demonstrated significantly higher odds of adjusted mortality (AOR 8.4, 95% CI 2.84–25.07, p < 0.001) than the patients with head/neck injury. This study found that the risks to mortality in the patients with a given AIS value of serious to critical injury in different injured body regions were not the same, even after controlling for confounding variables such as sex, age, comorbidities, and ISS.

Suggested Citation

  • Cheng-Shyuan Rau & Shao-Chun Wu & Pao-Jen Kuo & Yi-Chun Chen & Peng-Chen Chien & Hsiao-Yun Hsieh & Ching-Hua Hsieh, 2017. "Same Abbreviated Injury Scale Values May Be Associated with Different Risks to Mortality in Trauma Patients: A Cross-Sectional Retrospective Study Based on the Trauma Registry System in a Level I Trau," IJERPH, MDPI, vol. 14(12), pages 1-12, December.
  • Handle: RePEc:gam:jijerp:v:14:y:2017:i:12:p:1552-:d:122394
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    References listed on IDEAS

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    1. Cheng-Shyuan Rau & Shao-Chun Wu & Yi-Chun Chen & Peng-Chen Chien & Hsiao-Yun Hsieh & Pao-Jen Kuo & Ching-Hua Hsieh, 2017. "Effect of Age on Glasgow Coma Scale in Patients with Moderate and Severe Traumatic Brain Injury: An Approach with Propensity Score-Matched Population," IJERPH, MDPI, vol. 14(11), pages 1-12, November.
    2. Cheng-Shyuan Rau & Shao-Chun Wu & Peng-Chen Chien & Pao-Jen Kuo & Yi-Chun Chen & Hsiao-Yun Hsieh & Ching-Hua Hsieh, 2017. "Prediction of Mortality in Patients with Isolated Traumatic Subarachnoid Hemorrhage Using a Decision Tree Classifier: A Retrospective Analysis Based on a Trauma Registry System," IJERPH, MDPI, vol. 14(11), pages 1-10, November.
    3. Spencer C H Kuo & Pao-Jen Kuo & Yi-Chun Chen & Peng-Chen Chien & Hsiao-Yun Hsieh & Ching-Hua Hsieh, 2017. "Comparison of the new Exponential Injury Severity Score with the Injury Severity Score and the New Injury Severity Score in trauma patients: A cross-sectional study," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-12, November.
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    Cited by:

    1. Chien-En Tang & Hang-Tsung Liu & Pao-Jen Kuo & Yi-Chun Chen & Shiun-Yuan Hsu & Chih-Che Lin & Ching-Hua Hsieh, 2018. "Impact of Sexual Dimorphism on Trauma Patterns and Clinical Outcomes of Patients with a High-Risk Score of the Osteoporosis Self-Assessment Tool for Asians: A Propensity Score-Matched Analysis," IJERPH, MDPI, vol. 15(3), pages 1-12, February.
    2. Wei-Ti Su & Shao-Chun Wu & Chun-Ying Huang & Sheng-En Chou & Ching-Hua Tsai & Chi Li & Shiun-Yuan Hsu & Ching-Hua Hsieh, 2020. "Geriatric Nutritional Risk Index as a Screening Tool to Identify Patients with Malnutrition at a High Risk of In-Hospital Mortality among Elderly Patients with Femoral Fractures—A Retrospective Study ," IJERPH, MDPI, vol. 17(23), pages 1-9, November.

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