How well do principal diagnosis classifications predict disability 12 months postinjury?

Gabbe, Belinda; Simpson, Pamela; Lyons, Ronan A.; Polinder, Suzanne; Rivara, Frederick P.; Ameratunga, Shanthi; Derrett, Sarah; Haagsma, Juanita A.; Harrison, James Edward

doi:10.1136/injuryprev-2013-041037

Cited by 2 publications

(5 citation statements)

References 36 publications

(36 reference statements)

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“…Although models incorporating injury severity performed relatively well on physical measures, for psychosocial measures (the pain/discomfort and anxiety/depression components of the EQ-5D) they performed little better than chance; this is in keeping with previous findings 25. Pain and psychosocial outcomes were specifically excluded from the dimensions of function covered by the FCI15; this has previously been criticised 27 39.…”

Section: Discussionsupporting

confidence: 72%

“…Previous studies have found associations between anatomical injury and a range of physical outcomes 1–7 25 28 38. While some studies have found that the ISS is independently associated with functional outcomes,1 5 others have found that injuries to particular body regions or the presence of multi-trauma contribute variously to different outcome measures 1–7 38.…”

Section: Discussionmentioning

confidence: 99%

“…Dichotomisation of assessed outcomes is appropriate32 and has been used for these outcomes 25 27 28. However, it is possible that individual predictors may have greater or lesser effects at different levels of function.…”

Section: Discussionmentioning

confidence: 99%

“…This 8-point hierarchical scale has been validated for use in general trauma populations 24. A score of 5 or higher is representative of ‘independent living’,25 and this dichotomisation was used.…”

Section: Methodsmentioning

confidence: 99%

“…The base model used only age1–3 6 7 9 and gender,2 7 9 25 which are well-recognised and universally comparable predictors of trauma outcome. Patient age was not restricted, although sensitivity analyses with restricted age groups15 16 were performed and reported as supplementary data (online supplementary file 3).…”

Section: Methodsmentioning

confidence: 99%

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Comparison of revised Functional Capacity Index scores with Abbreviated Injury Scale 2008 scores in predicting 12-month severe trauma outcomes

2019

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IntroductionAnatomical injury as measured by the AIS often accounts for only a small proportion of variability in outcomes after injury. The predictive Functional Capacity Index (FCI) appended to the 2008 AIS claims to provide a widely available method of predicting 12-month function following injury.ObjectivesTo determine the extent to which AIS-based and FCI-based scoring is able to add to a simple predictive model of 12-month function following severe injury.MethodsAdult trauma patients were drawn from the population-based Victorian State Trauma Registry. Major trauma and severely injured orthopaedic trauma patients were followed up via telephone interview including Glasgow Outcome Scale—Extended, the EQ-5D-3L and return to work status. A battery of AIS-based and FCI-based scores, and a simple count of AIS-coded injuries were added in turn to a base model using age and gender.ResultsA total of 20 813 patients survived to 12 months and had at least one functional outcome recorded, representing 85% follow-up. Predictions using the base model varied substantially across outcome measures. Irrespective of the method used to classify the severity of injury, adding injury severity to the model significantly, but only slightly improved model fit. Across the outcomes evaluated, no method of injury severity assessment consistently outperformed any other.ConclusionsAnatomical injury is a predictor of trauma outcome. However, injury severity as described by the FCI does not consistently improve discrimination, or even provide the best discrimination compared with AIS-based severity scores or a simple injury count.

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Section: Discussionsupporting

confidence: 72%