INJURY SCALING AT AUTOPSY: THE COMPARISON WITH PREMORTEM CLINICAL DATA

The difference between injury scaling performed in the same patients on the basis of clinical information only and postmortem examination only is largely unknown. We compared scores in all 279 trauma patients who died in the Department of Critical Care Medicine at Auckland Hospital from 1982 through 1987 (93 percent blunt trauma, 4 percent penetrating trauma, 3 percent burns; median time until death--2 days) using both the 1980 and 1985 revisions of the Abbreviated Injury Scale (AIS-80, AIS-85) and derived Injury Severity Scores (ISS-80, ISS-85) where such scoring was based on clinical information only (CLAIS, CLISS) or postmortem findings only (PMAIS, PMISS). For the group as a whole, there was little difference in the distribution of scores between CLAIS and PMAIS or between CLISS and PMISS. However, CLISS-80 was different from PMISS-80 in 68 percent of individual patients. Most major differences between CLAIS and PMAIS (two AIS grades or more) occurred in the Head region, where injury scoring based on physiological features (e.g. coma) occurred without an anatomic injury of similar AIS grade, or in the Thorax region where therapy had either abolished the evidence of injury (e.g. pneumothorax) or injuries were discovered at postmortem examination which had not been appreciated clinically. Injury scaling data derived only from postmortem examination is not equivalent to that derived clinically. For maximum accuracy, postmortem data must be derived from an examination specifically guided by the needs of injury scaling and in full cognizance of injuries recognised and treated clinically.

• Availability:
  • Find a library where document is available. Order URL: http://worldcat.org/issn/00014575
• Corporate Authors:

  Pergamon Press, Incorporated

  Headington Hill Hall
  Oxford OX30BW,    
• Authors:
  • Streat, S J
  • Civil, I D
• Publication Date: 1990-6

Media Info

• Features: Figures; References; Tables;
• Pagination: p. 241-252
• Serial:
  • Accident Analysis & Prevention
  • Volume: 22
  • Issue Number: 3
  • Publisher: Elsevier
  • ISSN: 0001-4575
  • Serial URL: http://www.sciencedirect.com/science/journal/00014575

Subject/Index Terms

• TRT Terms: Alternatives analysis; Autopsies; Head; Injury severity; Thorax
• Identifier Terms: Abbreviated Injury Scale; Injury Severity Score
• Old TRIS Terms: Clinical data
• Subject Areas: Highways; Safety and Human Factors;

Filing Info

• Accession Number: 00496932
• Record Type: Publication
• Report/Paper Numbers: HS-040 775
• Files: TRIS
• Created Date: Aug 31 1990 12:00AM