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Cameron S Palmer - One of the best experts on this subject based on the ideXlab platform.
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the abbreviated Injury Scale is well described a letter to the editor re loftis et al evolution of the abbreviated Injury Scale 1990 2015
Traffic Injury Prevention, 2019Co-Authors: Cameron S Palmer, Hideo TohiraAbstract:AbstractObjective: A recent study published in this journal has provided a description and summary of changes made to the Abbreviated Injury Scale (AIS) through the 5 latest versions. However, there has already been a considerable body of related research published during the past decade.Methods: A brief narrative review of recent research in this field is presented.Results: Over the past decade, considerable research has been undertaken to describe the code set differences that have arisen between different AIS versions. Much of this research has been focused on developing or evaluating mapping tools to provide continuity in how the AIS has been used to describe Injury over time. In addition, severity changes and changes by body region have also been summarized for some AIS versions.Conclusions: The changes that have been successively introduced to the AIS since 1990 have been well documented, and validated strategies to enable registries to adjust for AIS change are well established. However, further re...
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The Abbreviated Injury Scale is well described: A letter to the Editor re: Loftis et al., “Evolution of the Abbreviated Injury Scale: 1990–2015”
Traffic Injury Prevention, 2019Co-Authors: Cameron S Palmer, Hideo TohiraAbstract:AbstractObjective: A recent study published in this journal has provided a description and summary of changes made to the Abbreviated Injury Scale (AIS) through the 5 latest versions. However, there has already been a considerable body of related research published during the past decade.Methods: A brief narrative review of recent research in this field is presented.Results: Over the past decade, considerable research has been undertaken to describe the code set differences that have arisen between different AIS versions. Much of this research has been focused on developing or evaluating mapping tools to provide continuity in how the AIS has been used to describe Injury over time. In addition, severity changes and changes by body region have also been summarized for some AIS versions.Conclusions: The changes that have been successively introduced to the AIS since 1990 have been well documented, and validated strategies to enable registries to adjust for AIS change are well established. However, further re...
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The Abbreviated Injury Scale is well described: A letter to the Editor re: Loftis et al., "Evolution of the Abbreviated Injury Scale: 1990-2015".
Traffic injury prevention, 2019Co-Authors: Cameron S Palmer, Hideo TohiraAbstract:Objective: A recent study published in this journal has provided a description and summary of changes made to the Abbreviated Injury Scale (AIS) through the 5 latest versions. However, there has al...
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defining major trauma using the 2008 abbreviated Injury Scale
Injury-international Journal of The Care of The Injured, 2016Co-Authors: Cameron S Palmer, Belinda J Gabbe, Peter CameronAbstract:Abstract Background The Injury Severity Score (ISS) is the most ubiquitous summary score derived from Abbreviated Injury Scale (AIS) data. It is frequently used to classify patients as ‘major trauma’ using a threshold of ISS >15. However, it is not known whether this is still appropriate, given the changes which have been made to the AIS codeset since this threshold was first used. This study aimed to identify appropriate ISS and New Injury Severity Score (NISS) thresholds for use with the 2008 AIS (AIS08) which predict mortality and in-hospital resource use comparably to ISS >15 using AIS98. Methods Data from 37,760 patients in a state trauma registry were retrieved and reviewed. AIS data coded using the 1998 AIS (AIS98) were mapped to AIS08. ISS and NISS were calculated, and their effects on patient classification compared. The ability of selected ISS and NISS thresholds to predict mortality or high-level in-hospital resource use (the need for ICU or urgent surgery) was assessed. Results An ISS >12 using AIS08 was similar to an ISS >15 using AIS98 in terms of both the number of patients classified major trauma, and overall major trauma mortality. A 10% mortality level was only seen for ISS 25 or greater. A NISS >15 performed similarly to both of these ISS thresholds. However, the AIS08-based ISS >12 threshold correctly classified significantly more patients than a NISS >15 threshold for all three severity measures assessed. Conclusions When coding injuries using AIS08, an ISS >12 appears to function similarly to an ISS >15 in AIS98 for the purposes of identifying a population with an elevated risk of death after Injury. Where mortality is a primary outcome of trauma monitoring, an ISS >12 threshold could be adopted to identify major trauma patients. Level of evidence Level II evidence—diagnostic tests and criteria.
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mapping abbreviated Injury Scale data from 1990 to 1998 versions a stepping stone in the contemporary evaluation of trauma
Injury-international Journal of The Care of The Injured, 2013Co-Authors: Cameron S Palmer, Jacelle Lang, Glen Russell, Natalie Dallow, Kathy Harvey, Belinda J Gabbe, Peter CameronAbstract:Abstract Introduction Many trauma registries have used the 1990 revision of the Abbreviated Injury Scale (AIS; AIS90) to code injuries sustained by trauma patients. Due to changes made to the AIS codeset since its release, AIS90-coded data lacks currency in the assessment of Injury severity. The ability to map between the 1998 revision of AIS (AIS98) and the current (2008) AIS version (AIS08) already exists. The development of a map for transforming AIS90-coded data into AIS98 would therefore enable contemporary Injury severity estimates to be derived from AIS90-coded data. Methods Differences between the AIS90 and AIS98 codesets were identified, and AIS98 maps were generated for AIS90 codes which changed or were not present in AIS98. The effectiveness of this map in describing the severity of trauma using AIS90 and AIS98 was evaluated using a large state registry dataset, which coded Injury data using AIS90 over several years. Changes in Injury Severity Scores (ISS) calculated using AIS90 and mapped AIS98 codesets were assessed using three distinct methods. Results Forty-nine codes (out of 1312) from the AIS90 codeset changed or were not present in AIS98. Twenty-four codes required the assignment of maps to AIS98 equivalents. AIS90-coded data from 78,075 trauma cases were used to evaluate the map. Agreement in calculated ISS between coded AIS90 data and mapped AIS98 data was very high (kappa = 0.971). The ISS changed in 1902 cases (2.4%), and the mean difference in ISS across all cases was 0.006 points. The number of cases classified as major trauma using AIS98 decreased by 0.8% compared with AIS90. A total of 3102 cases (4.0%) sustained at least one AIS90 Injury which required mapping to AIS98. Conclusions This study identified the differences between the AIS90 and AIS98 codesets, and generated maps for the conversion process. In practice, the differences between AIS90- and AIS98-coded data were very small. As a result, AIS90-coded data can be mapped to the current AIS version (AIS08) via AIS98, with little apparent impact on the functional accuracy of the mapped dataset produced.
A Turnbull - One of the best experts on this subject based on the ideXlab platform.
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the abbreviated Injury Scale as a predictor of outcome of severe head Injury
Intensive Care Medicine, 1995Co-Authors: A D Walder, P M Yeoman, A TurnbullAbstract:Objective This study examined the correlation between the worst abbreviated Injury Scale 1990 (AIS) intracranial severity score and outcome following severe head Injury.
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The abbreviated Injury Scale as a predictor of outcome of severe head Injury
Intensive care medicine, 1995Co-Authors: A D Walder, P M Yeoman, A TurnbullAbstract:This study examined the correlation between the worst abbreviated Injury Scale 1990 (AIS) intracranial severity score and outcome following severe head Injury. The initial CT scans of 109 severly head Injury patients were examined by a neuroradiologist and classified according to the worst applicable intracranial severity code from the AIS. This score was then correlated with the glasgow outcome Scale (GOS) at 6 months. For comparison, the GOS was also correlated with the diffuse Injury Scale (DIS) described by L.F. Marshall et al. [5], the worst post-resuscitation Glasgow coma score (GCS) in the first 24 h, and the head Injury outcome prediction tree described by Choi et al. [1]. Our results show Spearman rank correlation coefficients of 0.58 (p
Margaret R Slater - One of the best experts on this subject based on the ideXlab platform.
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description and repeatability of a newly developed spinal cord Injury Scale for dogs
Preventive Veterinary Medicine, 2009Co-Authors: Gwendolyn J Levine, Jonathan M Levine, Christine M Budke, Sharon C Kerwin, Arathi Vinayak, Bianca F Hettlich, Margaret R SlaterAbstract:The objectives of this study were to describe a new spinal cord Injury Scale for dogs, evaluate repeatability through determining inter-rater variability of scores, compare these scores to another established system (a modified Frankel Scale), and determine if the modified Frankel Scale and the newly developed Scale were useful as prognostic indicators for return to ambulation. A group of client-owned dogs with spinal cord Injury were examined by 2 independent observers who applied the new Texas Spinal Cord Injury Score (TSCIS) and a modified Frankel Scale that has been used previously. The newly developed Scale was designed to describe gait, postural reactions and nociception in each limb. Weighted kappa statistics were utilized to determine inter-rater variability for the modified Frankel Scale and individual components of the TSCIS. Comparisons were made between raters for the overall TSCIS score and between Scales using Spearman's rho. An additional group of dogs with surgically treated thoracolumbar disk herniation was enrolled to look at correlation of both scores with spinal cord signal characteristics on magnetic resonance imaging (MRI) and ambulatory outcome at discharge. The actual agreement between raters for the modified Frankel Scale was 88%, with a weighted kappa value of 0.93. The TSCIS had weighted kappa scores for gait, proprioceptive positioning and nociception components that ranged from 0.72 to 0.94. Correlation between raters for the overall TSCIS score was Spearman's rho=0.99 (P<0.001). Comparison of the overall TSCIS score to the modified Frankel score resulted in a Spearman's rho value of 0.90 (P<0.001). The modified Frankel score was weakly correlated with the length of hyperintensity of the spinal cord: L2 vertebral body length ratio on mid-sagittal T2-weighted MRI (Spearman's rho=-0.45, P=0.042) as was the overall TSCIS score (Spearman's rho=-0.47, P=0.037). There was also a significant difference in admitting modified Frankel scores (P=0.029) and admitting overall TSCIS scores (P=0.02) between dogs that were ambulatory at discharge and those that were not. Results from this study suggest that the TSCIS is an easy to administer Scale for evaluating canine spinal cord Injury based on the standard neurological exam and correlates well with a previously described modified Frankel Scale.
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Description and repeatability of a newly developed spinal cord Injury Scale for dogs.
Preventive veterinary medicine, 2009Co-Authors: Gwendolyn J Levine, Jonathan M Levine, Christine M Budke, Sharon C Kerwin, Arathi Vinayak, Bianca F Hettlich, Margaret R SlaterAbstract:The objectives of this study were to describe a new spinal cord Injury Scale for dogs, evaluate repeatability through determining inter-rater variability of scores, compare these scores to another established system (a modified Frankel Scale), and determine if the modified Frankel Scale and the newly developed Scale were useful as prognostic indicators for return to ambulation. A group of client-owned dogs with spinal cord Injury were examined by 2 independent observers who applied the new Texas Spinal Cord Injury Score (TSCIS) and a modified Frankel Scale that has been used previously. The newly developed Scale was designed to describe gait, postural reactions and nociception in each limb. Weighted kappa statistics were utilized to determine inter-rater variability for the modified Frankel Scale and individual components of the TSCIS. Comparisons were made between raters for the overall TSCIS score and between Scales using Spearman's rho. An additional group of dogs with surgically treated thoracolumbar disk herniation was enrolled to look at correlation of both scores with spinal cord signal characteristics on magnetic resonance imaging (MRI) and ambulatory outcome at discharge. The actual agreement between raters for the modified Frankel Scale was 88%, with a weighted kappa value of 0.93. The TSCIS had weighted kappa scores for gait, proprioceptive positioning and nociception components that ranged from 0.72 to 0.94. Correlation between raters for the overall TSCIS score was Spearman's rho=0.99 (P
Fiona Lecky - One of the best experts on this subject based on the ideXlab platform.
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using abbreviated Injury Scale ais codes to classify computed tomography ct features in the marshall system
BMC Medical Research Methodology, 2010Co-Authors: Mehdi Moazzez Lesko, Maralyn Woodford, Sarah J Obrien, Charmaine Childs, Laura White, Fiona LeckyAbstract:Background: The purpose of Abbreviated Injury Scale (AIS) is to code various types of Traumatic Brain Injuries (TBI) based on their anatomical location and severity. The Marshall CT Classification is used to identify those subgroups of brain injured patients at higher risk of deterioration or mortality. The purpose of this study is to determine whether and how AIS coding can be translated to the Marshall Classification Methods: Initially, a Marshall Class was allocated to each AIS code through cross-tabulation. This was agreed upon through several discussion meetings with experts from both fields (clinicians and AIS coders). Furthermore, in order to make this translation possible, some necessary assumptions with regards to coding and classification of mass lesions and brain swelling were essential which were all approved and made explicit. Results: The proposed method involves two stages: firstly to determine all possible Marshall Classes which a given patient can attract based on allocated AIS codes; via cross-tabulation and secondly to assign one Marshall Class to each patient through an algorithm. Conclusion: This method can be easily programmed in computer softwares and it would enable future important TBI research programs using trauma registry data.
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Using Abbreviated Injury Scale (AIS) codes to classify Computed Tomography (CT) features in the Marshall System
BMC medical research methodology, 2010Co-Authors: Mehdi Moazzez Lesko, Maralyn Woodford, Charmaine Childs, Laura White, Sarah J. O'brien, Fiona LeckyAbstract:The purpose of Abbreviated Injury Scale (AIS) is to code various types of Traumatic Brain Injuries (TBI) based on their anatomical location and severity. The Marshall CT Classification is used to identify those subgroups of brain injured patients at higher risk of deterioration or mortality. The purpose of this study is to determine whether and how AIS coding can be translated to the Marshall Classification Initially, a Marshall Class was allocated to each AIS code through cross-tabulation. This was agreed upon through several discussion meetings with experts from both fields (clinicians and AIS coders). Furthermore, in order to make this translation possible, some necessary assumptions with regards to coding and classification of mass lesions and brain swelling were essential which were all approved and made explicit. The proposed method involves two stages: firstly to determine all possible Marshall Classes which a given patient can attract based on allocated AIS codes; via cross-tabulation and secondly to assign one Marshall Class to each patient through an algorithm. This method can be easily programmed in computer softwares and it would enable future important TBI research programs using trauma registry data.
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lack of consistency in threat to life from single Injury abbreviated Injury Scale ais 4 codes in different body areas
2005Co-Authors: Maralyn Woodford, Alan Wrotchford, Omar Bouamra, D W Yates, Fiona LeckyAbstract:The Trauma Audit & Research Network (TARN) collects and audits major Injury data from half of all trauma receiving hospitals in England and Wales. At the time of extraction for this analysis there were 183,550 cases on the database. Included patients reach hospital alive and subsequently either die as a result of Injury, require intensive/high dependency care or interhospital transfer, or stay for more than 3 days. Our aim was to determine from an established trauma registry whether single Injury AIS 4 codes in different body areas result in a similar threat to life. Patients with single injuries giving an Abbreviated Injury Scale score of 4 were selected from the TARN database. Mortality rates were calculated with 95% confidence intervals (CI) by body area. This cross tabulation also included the median age and Glasgow Coma Score (GCS). There is variation in the mortality rates by body region for single AIS 4 injuries with lower extremity and external injuries having a higher crude mortality rate. In multivariate analysis there is a significantly lower odds of death associated with AIS 4 single injuries in the head and thorax areas than in other body regions. Single AIS 4 injuries present a significantly greater threat to life dependant on the body region injured.
A D Walder - One of the best experts on this subject based on the ideXlab platform.
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the abbreviated Injury Scale as a predictor of outcome of severe head Injury
Intensive Care Medicine, 1995Co-Authors: A D Walder, P M Yeoman, A TurnbullAbstract:Objective This study examined the correlation between the worst abbreviated Injury Scale 1990 (AIS) intracranial severity score and outcome following severe head Injury.
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The abbreviated Injury Scale as a predictor of outcome of severe head Injury
Intensive care medicine, 1995Co-Authors: A D Walder, P M Yeoman, A TurnbullAbstract:This study examined the correlation between the worst abbreviated Injury Scale 1990 (AIS) intracranial severity score and outcome following severe head Injury. The initial CT scans of 109 severly head Injury patients were examined by a neuroradiologist and classified according to the worst applicable intracranial severity code from the AIS. This score was then correlated with the glasgow outcome Scale (GOS) at 6 months. For comparison, the GOS was also correlated with the diffuse Injury Scale (DIS) described by L.F. Marshall et al. [5], the worst post-resuscitation Glasgow coma score (GCS) in the first 24 h, and the head Injury outcome prediction tree described by Choi et al. [1]. Our results show Spearman rank correlation coefficients of 0.58 (p