Revision of the International Classification of Diseases to include standardized descriptions of multiple injuries and injury severity

Nakahara, Shinji; Yokota, Junichiro

doi:10.2471/blt.10.078964

Cited by 15 publications

(13 citation statements)

References 5 publications

(15 reference statements)

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“…16 This is not surprising as other authors have also commented on the inadequacy of relying on ICD-9 codes for severe trauma. 20 Specifically, ICD-9 has only a limited number of codes for multiple injuries, 21 whereas AIS 2005-Military accounts for multiple wounds, including those resulting from explosive devices, 18 through the use of a dictionary organized by anatomical regions and incorporation of the degree of injury severity. 18,22 …”

Section: Discussionmentioning

confidence: 99%

Adherence to Published Antimicrobial Prophylaxis Guidelines for Wounded Service Members in the Ongoing Conflicts in Southwest Asia

et al. 2014

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In 2008, a clinical practice guideline (CPG) was developed for the prevention of infections among military personnel with combat-related injuries. Our analysis expands on a prior 6-month evaluation and assesses CPG adherence with respect to antimicrobial prophylaxis for U.S. combat casualties medically evacuated to Landstuhl Regional Medical Center over a 1-year period (June 2009 through May 2010), with an eventual goal of continuously monitoring CPG adherence and measuring outcomes as a function of compliance. We classified adherence to the CPG as receipt of recommended antimicrobials within 48 hours of injury. A total of 1106 military personnel eligible for CPG assessment were identified and 74% received antimicrobial prophylaxis. Overall, CPG compliance within 48 hours of injury was 75%. Lack of antimicrobial prophylaxis contributed 2 to 22% to noncompliance varying by injury category, whereas receipt of antibiotics other than preferred was 11 to 30%. For extremity injuries, antimicrobial prophylaxis adherence was 60 to 83%, whereas it was 80% for closed injuries and 68% for penetrating abdominal injuries. Overall, the results of our analysis suggest an ongoing need to improve adherence, monitor CPG compliance, and assess effectiveness.

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Section: Discussionmentioning

confidence: 99%

Adherence to Published Antimicrobial Prophylaxis Guidelines for Wounded Service Members in the Ongoing Conflicts in Southwest Asia

et al. 2014

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“…Unlike classifications such as the Abbreviated Injury Scale (AIS), there is no specific severity scale embedded within the ICD-10 classification 20. Nevertheless, ICD diagnoses have been shown to predict in-hospital mortality well (AUC >0.9) when combined into the International Classification of Injury Severity Score (ICISS) 21 22.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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“…The AIS is an anatomically based consensus-derived global severity scoring system that classifies every injury in each body region according to its relative severity on a six-point ordinal scale (1: minor, 2: moderate, 3: serious, 4: severe, 5: critical, and 6: maximal, currently untreatable). Only the highest AIS score in each body region is used, and the 3 most severely injured body regions have their score squared and added together to produce the ISS score, which range from 1 to 75 [22]. …”

Section: Methodsmentioning

confidence: 99%

Anxiety and Depression in Patients with Traumatic Spinal Cord Injury: A Nationwide Population-Based Cohort Study

et al. 2017

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BackgroundTraumatic spinal cord injury (tSCI) may involve new-onset anxiety and depression post-discharge. However, long-term population-based studies have lacked access to follow-up conditions in terms of new-onset anxiety and depression. The objective of this study was to estimate the long-term risk of new-onset anxiety and depression post-discharge.MethodsThe Longitudinal Health Insurance Database 2000 (LHID2000) from Taiwan’s National Health Insurance Research Database was used in this study. Individuals with tSCI were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes of 806 and 952 from 1999–2008. The comparison cohort (other health conditions group) was randomly selected from the LHID2000 and was 1:1 matched by age, sex, index year, and comorbidities to reduce the selection bias. All study participants were retrospectively followed for a maximum of 3 years until the end of follow-up, death, or new-onset anxiety (ICD-9-CM: 309.2–309.4) or depression (ICD-9-CM: 296.2, 296.5, 296.82, 300.4, 309.0–309.1, and 311). Persons who were issued a catastrophic illness card for tSCI were categorized as having a severe level of SCI (Injury Severity Score [ISS] ≥16). Poisson regression was used to estimate the incidence rate ratios of anxiety or depression between patients with tSCI and other health conditions. The relative risk of anxiety or depression was estimated using a Cox regression analysis, which was adjusted for potential confounding factors.ResultsUnivariate analyses showed that the tSCI patients (n = 3556) had a 1.33 times greater incidence of new-onset anxiety or depression (95% confidence interval [CI]: 1.12–1.57) compared to the other health conditions group (n = 3556). After adjusting for potential risk factors, the tSCI patients had a significant 1.29-fold increased risk of anxiety or depression compared to the group with other health conditions (95% CI: 1.09–1.53). Individuals with tSCI, including patients who were under the age of 35, patients who were males, patients who had a low income, and patients without a Charlson Comorbidity Index score, all had a higher long-term risk of anxiety or depression than the other health conditions group (IRRs: 1.84, 1.63, 1.29, and 1.39, respectively). For all tSCI patients, those with an Injury Severity Score (ISS) ≥16 had an almost 2-fold higher risk of anxiety or depression (adjusted Hazard Ratio: 1.85; 95% CI: 1.17–2.92) compared to those with ISS <16.ConclusionsOur findings indicated that tSCI patients have a high risk of anxiety or depression post-discharge, especially among the younger tSCI patients (age <50 years), compared with the other health conditions group. This information could help physicians understand the long-term risk of new-onset anxiety or depression in tSCI patients post-discharge.

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Revision of the International Classification of Diseases to include standardized descriptions of multiple injuries and injury severity

Cited by 15 publications

References 5 publications

Adherence to Published Antimicrobial Prophylaxis Guidelines for Wounded Service Members in the Ongoing Conflicts in Southwest Asia

Adherence to Published Antimicrobial Prophylaxis Guidelines for Wounded Service Members in the Ongoing Conflicts in Southwest Asia

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

Anxiety and Depression in Patients with Traumatic Spinal Cord Injury: A Nationwide Population-Based Cohort Study

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