# Presentation: 782099

## Multiple Injury Profiles

**M****ultiple ****I****njury ****P****rofiles**

**Israel National Center for Trauma and Emergency Medicine Research****,**
**Gertner Institute for Epidemiology and Health Policy Research, Israel**

- A summary of what we have done and learnt since Paris ICE meeting 2003
- Limor Aharonson-Daniel

## A tool for

- an injury descriptor, not a severity measure
**A tool for**
- presenting and reporting injury statistics
- comparing injury patterns in populations

**M****ultiple ****I****njury ****P****rofiles are**

- 2003 agreements

## Choice of groups

**“**We always remain loyal to the full matrix (36 rows) as the basic, most descriptive unit.”
- Further collapsing and grouping can be tailor-made by researchers based on study needs, frequency, clinical reasoning etc.

- 2003 agreements

**Too much detail obscures presentation**
**Body region is usually a good indicator**
**See “poster” file for excmples of different levels of detail**

## Excluding AIS=1 injuries

- The number of combinations may be inflated by a large number of superficial injuries that make no difference in terms of outcome or significant care provided.
- In order to reduce the number of combinations, exclude AIS=1 injuries from profile and see the effect

- 2003 agreements

## Excluding AIS=1 injuries

- Homework

**Excluding AIS=1 injuries**

## In Theory:

- Specific ICD codes corresponding to AIS=1 have to be selected and excluded from profile.
- In practice:
- It is not straight forward to assign specific ICD codes to correspond to AIS=1.

**2004: Plan A**

- Excluding AIS=1 injuries

## Excluding ICD diagnoses with AIS=1  was not possible.

- 2004:The problem

- Excluding AIS=1 injuries

## Build an AIS based matrix.

- Use for building multiple injury profiles.
- AIS=1 codes can be excluded and results compared.

- 2004: New Plan

- Excluding AIS=1 injuries

## AIS matrix is built but needs validation.

- We preferred to use an accepted method.
- AIS six body regions were used to build multiple injury profiles.
- A comparison of these profiles with and without AIS=1 injuries was done.

- 2004: Current status

- Excluding AIS=1 injuries

## Multiple Injury Profiles using AIS regions

**M****ultiple ****I****njury ****P****rofiles using AIS regions**

- Building a profile using AIS six body regions:
- Head, Face, Chest, Abdomen, Extremities, External
- A patient has an injury to the Head and Chest
- His profile would be:  H _ C _ _ _

- The following are results of the analysis of road traffic casualties from 1998-2002, a total of 23848 patients using AIS body regions

## Distribution of body regions injured

- All patients: 23848,

**Distribution of body regions injured**

**All injuries**

## Distribution of body regions injured

- All patients: 23848, Excluding AIS=1, 19014 patients

**Distribution of body regions injured**

**All injuries (red) and when excluding AIS=1 (yellow)**

## Distribution of MIP for patients with Head injuries

**Distribution of MIP for patients with Head injuries**

**All injuries (red) and when excluding AIS=1 (yellow)**

## Distribution of critical injuries (ISS 25+)

**Distribution of critical injuries (ISS 25+)**

**All injuries (red) and when excluding AIS=1 (yellow)**

## Distribution of inpatient mortality rate

**Distribution of inpatient mortality rate**

**All injuries (red) and when excluding AIS=1 (yellow)**

## What do you think?

- Should we exclude AIS=1?

## Put efforts into associating individual ICD diagnoses with AIS severity so that this will be checked on the original matrix based MIP.

- AIS matrix needs to be experimented and validated on different populations

## Thanks for your attention

**Thanks for your attention**