Comparison of manual and computer assigned injury severity scores.


Journal

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
ISSN: 1475-5785
Titre abrégé: Inj Prev
Pays: England
ID NLM: 9510056

Informations de publication

Date de publication:
08 2020
Historique:
received: 06 03 2019
revised: 19 06 2019
accepted: 20 06 2019
pubmed: 14 7 2019
medline: 8 9 2021
entrez: 14 7 2019
Statut: ppublish

Résumé

The study objective was to compare the ISS manually assigned by hospital personnel and those generated by the ICDPIC software for value agreement and predictive power of length of stay (LOS) and mortality. We used data from the 2010-2016 trauma registry of a paediatric trauma centre (PTC) and 2014 National Trauma Data Bank (NTDB) hospitals that reported manually coded ISS. Agreement analysis was performed between manually and computer assigned ISS with severity groupings of 1-8, 9-15, 16-25 and 25-75. The prediction of LOS was compared using coefficients of determination (R The proportion of agreement between manually and computer assigned ISS in PTC data was 0.84 and for NTDB was 0.75. Analysing predictive power for LOS in the PTC sample, the R Manually and computer assigned ISS had strong comparative agreement for minor injuries but did not correlate well for critical injuries (ISS=25-75). The LOS and mortality predictive power were significantly higher for manually assigned ISS when compared with computer assigned ISS in both PTC and NTDB data sets. Thus, hospitals should be cautious about transitioning to computer assigned ISS, specifically for patients who are critically injured.

Sections du résumé

BACKGROUND
The study objective was to compare the ISS manually assigned by hospital personnel and those generated by the ICDPIC software for value agreement and predictive power of length of stay (LOS) and mortality.
METHODS
We used data from the 2010-2016 trauma registry of a paediatric trauma centre (PTC) and 2014 National Trauma Data Bank (NTDB) hospitals that reported manually coded ISS. Agreement analysis was performed between manually and computer assigned ISS with severity groupings of 1-8, 9-15, 16-25 and 25-75. The prediction of LOS was compared using coefficients of determination (R
RESULTS
The proportion of agreement between manually and computer assigned ISS in PTC data was 0.84 and for NTDB was 0.75. Analysing predictive power for LOS in the PTC sample, the R
CONCLUSIONS
Manually and computer assigned ISS had strong comparative agreement for minor injuries but did not correlate well for critical injuries (ISS=25-75). The LOS and mortality predictive power were significantly higher for manually assigned ISS when compared with computer assigned ISS in both PTC and NTDB data sets. Thus, hospitals should be cautious about transitioning to computer assigned ISS, specifically for patients who are critically injured.

Identifiants

pubmed: 31300467
pii: injuryprev-2019-043224
doi: 10.1136/injuryprev-2019-043224
doi:

Types de publication

Comparative Study Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

330-333

Informations de copyright

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Lauren Otto (L)

Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Ohio State University College of Medicine, Columbus, Ohio, USA.

Angela Wang (A)

Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
University of Virginia College and Graduate School of Arts and Sciences, Charlottesville, Virginia, USA.

Krista Wheeler (K)

Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.

Junxin Shi (J)

Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.

Jonathan I Groner (JI)

Ohio State University College of Medicine, Columbus, Ohio, USA.
Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.

Kathryn J Haley (KJ)

Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA.

Kathryn E Nuss (KE)

Ohio State University College of Medicine, Columbus, Ohio, USA.
Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA.

Henry Xiang (H)

Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA Henry.Xiang@nationwidechildrens.org.
Ohio State University College of Medicine, Columbus, Ohio, USA.
Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.

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