Classifying trauma severity based on hospital discharge diagnoses: Validation of an ICD-9CM to AIS-85 conversion table

Research output: Contribution to journalArticle

Abstract

This report describes the development and validation of a computerized system for converting ICD-9CM rubrics to Abbreviated Injury Scale (AIS) scores. In collaboration with the Committee on Injury Scaling of the Association for the Advancement of Automotive Medicine, AIS-85 scores were assigned to 2, 062 injury-related ICD-9CM rubrics. To validate the conversion table, AIS and Injury Severity Scores (ISS), derived using the conversion, were compared with those obtained by reviewing the complete medical record for 1, 120 trauma cases. Percent agreement in maximum AIS scores (MAXAIS) ranged from 48% for head/neck injuries to 74% for extremity injuries. In 68% of the cases, grouped ISS scores (one to 12; 13 to 19; 20+) were in agreement. Previous studies of the interrater reliability of AIS coding directly from the medical charts have shown that agreement in MAXAIS scores ranges, on average, between 62% for head/neck injuries to 76% for extremity injuries. Grouped ISS scores agree, on average, 75% of the time. The results show that while the computerized conversion is not perfect, it provides reasonably good information on severity that might otherwise be unavailable for large population-based research and evaluation. This paper discusses the potential applications of the conversion table with specific attention to its use in evaluating the extent of trauma care regionalization.

Original languageEnglish (US)
Pages (from-to)412-422
Number of pages11
JournalMedical Care
Volume27
Issue number5
StatePublished - 1989

Fingerprint

Abbreviated Injury Scale
trauma
Injury Severity Score
Wounds and Injuries
Neck Injuries
Craniocerebral Trauma
Extremities
Clinical Coding
Medical Records
Medicine
regionalization
scaling
coding
Population

Keywords

  • Abbreviated Injury Scale
  • ICD-9CM
  • Injury severity scores
  • Severity of illness
  • Trauma

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

@article{4fe95569203d43bca44efddc5995906d,
title = "Classifying trauma severity based on hospital discharge diagnoses: Validation of an ICD-9CM to AIS-85 conversion table",
abstract = "This report describes the development and validation of a computerized system for converting ICD-9CM rubrics to Abbreviated Injury Scale (AIS) scores. In collaboration with the Committee on Injury Scaling of the Association for the Advancement of Automotive Medicine, AIS-85 scores were assigned to 2, 062 injury-related ICD-9CM rubrics. To validate the conversion table, AIS and Injury Severity Scores (ISS), derived using the conversion, were compared with those obtained by reviewing the complete medical record for 1, 120 trauma cases. Percent agreement in maximum AIS scores (MAXAIS) ranged from 48{\%} for head/neck injuries to 74{\%} for extremity injuries. In 68{\%} of the cases, grouped ISS scores (one to 12; 13 to 19; 20+) were in agreement. Previous studies of the interrater reliability of AIS coding directly from the medical charts have shown that agreement in MAXAIS scores ranges, on average, between 62{\%} for head/neck injuries to 76{\%} for extremity injuries. Grouped ISS scores agree, on average, 75{\%} of the time. The results show that while the computerized conversion is not perfect, it provides reasonably good information on severity that might otherwise be unavailable for large population-based research and evaluation. This paper discusses the potential applications of the conversion table with specific attention to its use in evaluating the extent of trauma care regionalization.",
keywords = "Abbreviated Injury Scale, ICD-9CM, Injury severity scores, Severity of illness, Trauma",
author = "Mackenzie, {Ellen J} and Steinwachs, {Donald M.} and Belavadi Shankar",
year = "1989",
language = "English (US)",
volume = "27",
pages = "412--422",
journal = "Medical Care",
issn = "0025-7079",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Classifying trauma severity based on hospital discharge diagnoses

T2 - Validation of an ICD-9CM to AIS-85 conversion table

AU - Mackenzie, Ellen J

AU - Steinwachs, Donald M.

AU - Shankar, Belavadi

PY - 1989

Y1 - 1989

N2 - This report describes the development and validation of a computerized system for converting ICD-9CM rubrics to Abbreviated Injury Scale (AIS) scores. In collaboration with the Committee on Injury Scaling of the Association for the Advancement of Automotive Medicine, AIS-85 scores were assigned to 2, 062 injury-related ICD-9CM rubrics. To validate the conversion table, AIS and Injury Severity Scores (ISS), derived using the conversion, were compared with those obtained by reviewing the complete medical record for 1, 120 trauma cases. Percent agreement in maximum AIS scores (MAXAIS) ranged from 48% for head/neck injuries to 74% for extremity injuries. In 68% of the cases, grouped ISS scores (one to 12; 13 to 19; 20+) were in agreement. Previous studies of the interrater reliability of AIS coding directly from the medical charts have shown that agreement in MAXAIS scores ranges, on average, between 62% for head/neck injuries to 76% for extremity injuries. Grouped ISS scores agree, on average, 75% of the time. The results show that while the computerized conversion is not perfect, it provides reasonably good information on severity that might otherwise be unavailable for large population-based research and evaluation. This paper discusses the potential applications of the conversion table with specific attention to its use in evaluating the extent of trauma care regionalization.

AB - This report describes the development and validation of a computerized system for converting ICD-9CM rubrics to Abbreviated Injury Scale (AIS) scores. In collaboration with the Committee on Injury Scaling of the Association for the Advancement of Automotive Medicine, AIS-85 scores were assigned to 2, 062 injury-related ICD-9CM rubrics. To validate the conversion table, AIS and Injury Severity Scores (ISS), derived using the conversion, were compared with those obtained by reviewing the complete medical record for 1, 120 trauma cases. Percent agreement in maximum AIS scores (MAXAIS) ranged from 48% for head/neck injuries to 74% for extremity injuries. In 68% of the cases, grouped ISS scores (one to 12; 13 to 19; 20+) were in agreement. Previous studies of the interrater reliability of AIS coding directly from the medical charts have shown that agreement in MAXAIS scores ranges, on average, between 62% for head/neck injuries to 76% for extremity injuries. Grouped ISS scores agree, on average, 75% of the time. The results show that while the computerized conversion is not perfect, it provides reasonably good information on severity that might otherwise be unavailable for large population-based research and evaluation. This paper discusses the potential applications of the conversion table with specific attention to its use in evaluating the extent of trauma care regionalization.

KW - Abbreviated Injury Scale

KW - ICD-9CM

KW - Injury severity scores

KW - Severity of illness

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=0024650716&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024650716&partnerID=8YFLogxK

M3 - Article

C2 - 2649755

AN - SCOPUS:0024650716

VL - 27

SP - 412

EP - 422

JO - Medical Care

JF - Medical Care

SN - 0025-7079

IS - 5

ER -