| With the development of society, the incidence of trauma is continuously increasing. Trauma is playing a more and more important role in affecting people's health. Trauma care is a principal task of military hospitals of different levels. Researches on trauma prevention and curing are among the main job of military hospitals and researching institutes. Among the researches, those on techniques of trauma severity scoring are the basic content and the precondition of advancing researches on other aspects of trauma. Established in 1970s, Abbreviated injury scale (AIS) is now admitted and used by most professionals and organizations in the field of trauma and has become the basic of trauma severity scoring and survival probability predicting.hi China, researches on trauma severity scoring were launched more recently and most of them were only involving copying the methods of foreign countries that are not always suitable for Chinese patients. And the standards of trauma severity scoring are not normal and consentaneous. On account of these, to create a simple, easily to use, standardized method for trauma severity scoring is very important and urgent in China.At present, ICD-9CM is commonly used as the diagnostic coding standard of diseases in all military hospitals in China. To exploit enormous data in database of abstracts of medical records, we considered establishing a path of converting ICD-9CM codes of traumatic diseases into AIS-90 codes. It can be used to score the severity of injury for patients without any extra costs.In this study, the AIS system refers to the 1998 revision of 1990 release of AIS newly published by Association for Advancement of Automobile Medicine (AAAM). The ICD-9CM system refers to the guide for using thestandards of names and codes of diseases diagnosis and surgical operation, composed by Liu Haiyi and He Liande. The database of abstracts of medical records used in this study was provided by the Health Information Center, Health Department of General Ministry of Logistic. The database includes 301,854 inpatients of trauma in 263 military hospitals from 1995 to 1998.1. Decompose all items of AIS-90 codes and learn the rules and laws of coding. All items of AIS-90 codes were decomposed into five digitals according to their meanings and then the five digitals were reunited to two parts, one represent the categories of trauma diseases which can be named as subcategory (the first four digits of the whole AIS-90 codes), the other represent the type and severity of injuries (the last three digits of the whole AIS-90 codes). All 1341 items of AIS-90 codes grouped into 288 subcategories. AIS value, the last digit of AIS-90 codes, represents the severity of the injury itself and its values vary from 1 (representing the most minor injury) to 6 (representing the maximum injury).2. Draft the corresponding relation table. The corresponding relations were set up for the ICD-9CM codes and AIS-90 codes whose meanings were the same by and large. For the ICD-9CM codes that have wider meanings than AIS-90 codes, their corresponding relations with the subcategories that similarly have wider meanings were set up. Among all 769 items of ICD-9CM codes representing trauma diseases, 207 items have been given reliable corresponding relations with AIS-90 codes.3. Processing of trauma information in database. Using the database, we classified the trauma patients by their ICD-9CM codes of the first discharge diagnosis. Counting their descriptive statistic, we worked out some certain statistical indices for each ICD-9CM code of trauma diseases and then screened out several of them highly associated with injury severity in terms of medical theories and knowledge. Meanwhile, following the path firstly used by Turner Osier, Ps (probability of survival) of each ICD-9CM code of trauma diseases was calculated for the sake of validation of correspondingVIrelation table.4. Establishment of corresponding relations of ICD-9CM codes of trauma diseases with AIS v... |
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