Not all trauma registries use the same AIS revision at any given time worldwide, registries implement newer AIS revisions whenever considered necessary at a local level. ĪIS code sets are periodically revised to better reflect contemporary performance of trauma systems. Also, the ISS has substantial limitations, including in the prediction of outcome after serious injury. However, in recent years focus on outcome measures in trauma care has shifted from fatal to nonfatal outcomes. This threshold was adopted following evaluation of mortality rates in the North American Major Trauma Outcome Study in the 1980s. The ISS is commonly used to define major trauma (MT) using an ISS ≥ 16. Although based on expert opinion, the ISS has persevered for over 40 years as the ‘gold standard’ of injury scoring. AIS coding, and AIS-derived scores such as the Injury Severity Score (ISS) are used to identify and classify injured patients within trauma systems, and can also be used as a component of risk adjustment and benchmarking using mortality prediction models. The Abbreviated Injury Scale (AIS) provides an anatomically-based, mortality-weighted code set used to classify injury severity.
Prognostic and epidemiological, level III. Defining MT using appropriate ISS thresholds is important for quality indicators, comparing datasets and adjusting for injury severity. This confirms studies evaluating mapped datasets, and is the first to present an evaluation of implementation of AIS15 on registry datasets. ISS08 ≥ 11 and ISS15 ≥ 12 perform similarly to a threshold ISS98 ≥ 16 for in-hospital mortality and ICU admission. Mortality risks did not differ significantly between AIS08 and AIS15. Thirty-nine thousand three hundred seventeen patients were included. Different ISS thresholds for MT and their corresponding observed mortality and intensive care (ICU) admission rates were compared between AIS98, AIS08, and AIS15 with Chi-square tests and logistic regression models. MethodsĪ retrospective observational cohort study including all primary admitted trauma patients was performed (in 2013–2014 AIS98 was used, in 2015–2016 AIS08, AIS08 mapped to AIS15). The aim of this study was to determine effects of different AIS revisions (1998, 20) on clinical outcome measures. A threshold Injury Severity Score (ISS) ≥ 16 is common in classifying major trauma (MT), although the Abbreviated Injury Scale (AIS) has been extensively revised over time.
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