Progress in characterizing anatomic injury

Copes, Wayne S.; Sacco, William J.; Champion, Howard R.; Bain, Lawrence W.; Gann, Donald S.; MacKenzie, Ellen; Schwaitzberg, Steven; Gennarelli, Thomas

Affiliations

¹Washington Hospital Center, Washington, D.C.

²University of Maryland, Baltimore, MD

³Johns Hopkins University, Baltimore, MD

⁴New England Medical Center, Boston, MA

⁵University of Pennsylvania, Philadelphia, PA

Abstract

A three-valued description of anatomic injury is presented. Anatomic profile (AP) components A, B and C summarize serious injuries (>AIS 2) to the head/brain or spinal cord; to the thorax or front of the neck; and all remaining serious injuries. Relationships between AP components and survival rate reaffirms the seriousness of head injury. Logistic function models relating AP components and the Injury Severity Score (ISS) to survival probability were based on 20,946 Major Trauma Outcome Study (MTOS) patients (9.2% mortality rate) submitted through 1986. Model performance comparisons were based on 5,939 MTOS patients (7.8% mortality rate) submitted during 1987. The AP better discriminated survivors from non-survivors and provided a 31% increase in sensitivity when compared with the ISS. Neither the ISS nor the AP alone reliably predict patient outcome. The predictive power of methods for estimating patient survival probability which include physiologic indices or profiles, patient age and an anatomic profile should be compared with current methods. The AP, which is based on the severity and location of all serious injuries, provides a more rational basis for comparing patient samples than the ISS.

Cited Works (7)

Year	Entry
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1985	The Abbreviated Injury Scale 1985 Revision. Arlington Heights, IL: Association for the Advancement of Automotive Medicine (AAAM); 1985.
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1989	Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flanagan ME. A revision of the Trauma Score. J Trauma. May 1989;29(5):623-629.
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Cited By (3)

Year	Entry
1991	Copes WS, Dickman FB, Champion HR, Sacco WJ. Motorcycle injuries: an MTOS perspective. In: 35th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 7, 1991; Toronto, Canada.269-284.
1996	Van Camp L, Dechamps M, Sabbe M, Vanderschot P, Delooz H, Broos P. Assessement of the predictive validity of the injury impairment scale in multiple injured patients with a head injury. In: 40th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 7-9, 1996; Vancouver, BC.199-212.
2005	Moore L, Lavoie A, Le Sage N, Liberman M, Bergeron E. A second injury in the same body region is associated with lower mortality than a second injury in a different body region. In: 49th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 12-14, 2005; Boston, MA.53-61.