Multiple Injury Profiles

Multiple Injury Profiles – an ICE project led by Limor Aharonson-Daniel, PhD, Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health policy Research, Israel.

Multiple injuries are associated with increased severity, higher mortality and often require more complex care and facilities. Previous data summary methods included selecting a primary injury, predefining injury combinations and recording them and coding “multiple injury” with no further detail. These methods all have serious flaws.

The objective of this project is to create a new systematic approach for summarizing multiple-injury diagnosis data into patient injury profiles which will maintain the detail of the injury yet facilitate statistical analysis.

ICD-9-CM injury diagnosis codes are classified using a modification of the Barell body region by nature of injury diagnosis matrix, then matrix units are used to group by body region, injury nature or a combination of both.

Profiles describe patients injury combinations, enabling the analysis of populations of patients, and not only the study of injuries.

Previous results have shown that the use of injury profiles improves the understanding of casemix and can be useful for efficient staffing in multidisciplinary trauma teams and for various comparisons across time and place.

One of the problems raised at the previous ICE meeting (Paris) and shown in a poster in Vienna is that with the increase in detail in matrix structure, the number of combinations grew so much that we lost the ability to comprehend the full picture. The balance between level of detail necessary and obtaining useful results is therefore sought.

Vienna ICE meeting consequently focused on the refinement of this application, through the exclusion of minor injuries, those with Abbreviated Injury Scale (AIS)=1 severity. Problems of matching ICD-9 codes with associated AIS severity were discussed and the use of AIS body region groups for MIP was demonstrated. It was decided to pursue the examination of the effect of the exclusion of AIS=1 injuries on injury profiles when using original matrix terminology. ICDMAP will be used for the conversion between ICD and AIS codes.