Comparison of alternative methods for assessing injury severity based on anatomic Descriptors

Background: There is mounting confusion as to which anatomic scoring system s can be used to adequately control for trauma case mis when predicting pat ient survival. Methods: Several Abbreviated Injury Scale (AIS) and International Classific ation of Disease Clinical (ICD-9CM) -based methods of scoring severity were compared by using data from the Pennsylvania Trauma Outcome Study, By usin g a design dataset, the probability of survival was modeled as a function o f each score or profile. Resulting coefficients were used to derive expecte d probabilities in a test dataset; expected and observed probabilities were then compared by using standard measures of discrimination and calibration . Results: The modified Anatomic Profile, Anatomic Profile, and New Injury Se verity Score outperformed the International Classification of Disease-based Injury Severity Score. This finding remains true when AIS values are obtai ned by means of a conversion from International Classification of Disease t o AIS, Conclusion: Results support the integrity of the AIS and argue for its cont inued use in research and evaluation. The modified Anatomic Profile, Anatom ic Profile, and New Injury Severity Score, however, should be used in prefe rence to the Injury Severity Score as an overall measure of severity.