Proper coding of the Abbreviated Injury Scale: can clinical parameters help as surrogates in estimating blood loss?

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Markus BurkhardtTraumaRegister DGU

Abstract

The Abbreviated Injury Scale (AIS) requires the estimation of the lost blood volume for some severity assignments. This study aimed to develop a rule of thumb for facilitating AIS coding by using objective clinical parameters as surrogate markers of blood loss. Using the example of pelvic ring fractures, a retrospective analysis of TraumaRegister DGU(®) data from 2002 to 2011 was performed. As potential surrogate markers of blood loss, we recorded the hemoglobin (Hb) level, systolic blood pressure (SBP), base excess (BE), Quick's value, units of packed red blood cells (PRBCs) transfused before intensive care unit (ICU) admission, and mortality within 24 h. We identified 11,574 patients with pelvic ring fractures (Tile/OTA classification: 39 % type A, 40 % type B, 21 % type C). Type C fractures were 73.1 % AISpelvis 4 and 26.9 % AISpelvis 5. Type B fractures were 47 % AISpelvis 3, 47 % AISpelvis 4, and 6 % AISpelvis 5. In type C fractures, cut-off values of <7 g/dL Hb, <90 mmHg SBP, <-9 mmol/L BE, <35 % Quick's value, >15 units PRBCs, and death within 24 h had a positive predictive value of 47 % and a sensitivity of 62 % for AISpelvis 5. In type B fractures, these cut-off values had poor sensitivity (48 %) and positive predictiv...Continue Reading

References

Feb 19, 1999·Journal of the American College of Surgeons·W F Fallon
May 1, 1996·The Journal of the American Academy of Orthopaedic Surgeons·M Tile
May 14, 2003·Archives of Surgery·C Craig BlackmoreFrederick P Rivara
Jun 13, 2006·The Journal of Trauma·Nedim YücelUNKNOWN Polytrauma Study Group of the German Trauma Society
Dec 13, 2006·The Journal of Trauma·Thein HlaingMary Aaland
Jun 17, 2011·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Shahriar ZehtabchiN Clay Mann
Feb 23, 2012·Clinical Orthopaedics and Related Research·Joerg H HolsteinUNKNOWN Working Group Mortality in Pelvic Fracture Patients
Aug 24, 2012·Critical Care : the Official Journal of the Critical Care Forum·Markus BurkhardtUNKNOWN German Pelvic Injury Register of the Deutsche Gesellschaft für Unfallchirurgie
Oct 7, 2014·Injury·UNKNOWN TraumaRegister DGU(®)

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Citations

Oct 7, 2014·Injury·Markus BurkhardtUNKNOWN German Pelvic Injury Register
Jul 1, 2017·Abdominal Radiology·Andrew B RosenkrantzRichard Duszak
May 24, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Andreas HöchUNKNOWN German Pelvic Trauma Registry
Aug 26, 2019·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·UNKNOWN 2018 ENA Clinical Practice Guideline CommitteeUNKNOWN Administrative Staff:

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