BEYOND THE SCALPEL MEASUREMENT OF DISABILITY AFTER MULTIPLE INJURIES - THE FUNCTIONAL INDEPENDENCE MEASURE

Collection of data about injured patients must include a description o f the injuries using the International Classification of Disease (ICD9 ) and their severity using the Anatomical Injury Scale (AIS) from whic h the Injury Severity Score (ISS) is calculated. This method was devel oped for assessing the risk of mortality and is a good way of defining the extent of injury or impairment. Morbidity after injury is equally important. The terms ''disability'', (relating to the individual pers on's behaviour and performance of activities) and ''handicap'' (relati ng more to the disadvantage for a given patient in society) are accept ed as the two main sub headings of long term morbidity. There are limi tations to total overall health measurements and a functional disabili ty approach is necessary for patients with multiple injuries. Of the d ifferent assessment tools the Functional Independence Measure, origina lly developed in Buffalo, USA, has been chosen as the most reliable an d valid as it has the additional advantage of a large database contain ing the records of 200000 patients throughout the world. This has been introduced at the Royal London Hospital to measure the disability out come of patients brought there by the Helicopter Emergency Medical Ser vice.