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Impact of Adapting the Abbreviated Injury Scale (AIS)-2005 from AIS-1998 on Injury Severity Scores and Clinical Outcome

Author

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  • Shiun-Yuan Hsu

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
    These authors contribute equally to this paper.)

  • Shao-Chun Wu

    (Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
    These authors contribute equally to this paper.)

  • Cheng-Shyuan Rau

    (Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan)

  • Ting-Min Hsieh

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan)

  • Hang-Tsung Liu

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan)

  • Chun-Ying Huang

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan)

  • Sheng-En Chou

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan)

  • Wei-Ti Su

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan)

  • Ching-Hua Hsieh

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan)

Abstract

Background: In recent years, several versions of the Abbreviated Injury Scale (AIS) were updated and published. It was reported that the codeset in the dictionary of AIS-2005 had significant change from that of AIS-1998. This study was designed to evaluate the potential impact of adapting the AIS-2005 codeset from the AIS-1998 in an established trauma system of a single level I trauma center. The patients’ outcome was measured in different Injury Severity Score (ISS) strata according to the double-coded injuries in a three-year period. Methods: The double-coded injuries sustained by 7520 trauma patients between 1 January, 2016, and 31 December, 2018, in a level I trauma center were used to compare the patient injury characteristics and outcomes between AIS-1998 and AIS-2005 and under different ISS strata, defined as <16 (mild to moderate injury), 16–24 (severe injury), and >24 (critical injury). Results: The mean ISS was significantly lower using AIS-2005 than using AIS-1998 (7.5 ± 6.3 vs. 8.3 ± 7.1, respectively, p < 0.001). AIS-2005 scores in the body regions of the head/neck (2.94 ± 1.08 vs. 3.40 ± 1.15, respectively, p < 0.001) and extremity (2.19 ± 0.56 vs. 2.24 ± 0.58, respectively, p < 0.001), but not in other body regions, were significantly lower than AIS-1998 scores. The critically injured patients (ISS >24), but not severely injured patients or patients with mild-to-moderate injury, coded by AIS-2005 had a significantly higher mortality rate (34.2% vs. 26.2%, respectively, p = 0.031) than did patients coded by AIS-1998. The rate of intensive care unit admission was significantly higher for patients in all ISS strata after adapting AIS-2005 as the scoring system than after adapting AIS-1998. Regarding patients with major trauma, which was defined as ISS > 15, the number of patients with major trauma in this study was 17.0% ( n = 1276) for AIS-1998 and 9.7% ( n = 733) for AIS-2005. As a consequence, the mortality rate of patients with major trauma was significantly higher in AIS-2005 than in AIS-1998 (15.4% vs. 9.1%, respectively, p < 000.1). Conclusions: In this study, we revealed that the adaptation of AIS-2005 from AIS-1998 had resulted in a significant decrease of severity scores in the measurement of the same injuries. The number of head/neck injuries classified as 16–24 was the key difference between AIS-1998 and AIS-2005. Furthermore, critically injured patients who had ISS > 24 coded by AIS-2005 had significantly higher mortality rates than did the patients coded by AIS-1998. This study also indicated that a direct comparison of the measurements that are generated from these two AIS versions can produce misleading results.

Suggested Citation

  • Shiun-Yuan Hsu & Shao-Chun Wu & Cheng-Shyuan Rau & Ting-Min Hsieh & Hang-Tsung Liu & Chun-Ying Huang & Sheng-En Chou & Wei-Ti Su & Ching-Hua Hsieh, 2019. "Impact of Adapting the Abbreviated Injury Scale (AIS)-2005 from AIS-1998 on Injury Severity Scores and Clinical Outcome," IJERPH, MDPI, vol. 16(24), pages 1-10, December.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:24:p:5033-:d:296385
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    References listed on IDEAS

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    1. Shu-Hui Peng & Chun-Ying Huang & Shiun-Yuan Hsu & Li-Hui Yang & Ching-Hua Hsieh, 2018. "The Preschool-Aged and School-Aged Children Present Different Odds of Mortality than Adults in Southern Taiwan: A Cross-Sectional Retrospective Analysis," IJERPH, MDPI, vol. 15(5), pages 1-11, April.
    2. 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.
    3. Shao-Chun Wu & Cheng-Shyuan Rau & Spencer C. H. Kuo & Peng-Chen Chien & Hsiao-Yun Hsieh & Ching-Hua Hsieh, 2018. "The Reverse Shock Index Multiplied by Glasgow Coma Scale Score (rSIG) and Prediction of Mortality Outcome in Adult Trauma Patients: A Cross-Sectional Analysis Based on Registered Trauma Data," IJERPH, MDPI, vol. 15(11), pages 1-12, October.
    4. 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. 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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