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The AIS-2005 Revision in Severe Traumatic Brain Injury: Mission Accomplished or Problems for Future Research? Ann Adv Automot Med 2010;54:233-8

Date

11/06/2010

Pubmed ID

21050606

Pubmed Central ID

PMC3242550

Scopus ID

2-s2.0-78650893972 (requires institutional sign-in at Scopus site)   43 Citations

Abstract

The Abbreviated Injury Scale (AIS) is commonly used to score injury severity and describe types of injuries. In 2005, the AIS-Head section was revised to capture more detailed information about head injuries and to better reflect their clinical severity, but the impact of these changes is largely unknown. The purpose of this study was to compare AIS-1998 and AIS-2005 coding of traumatic brain injuries (TBI) using medical records at a single Level I trauma center. We included patients with severe TBI (Glasgow Coma Scale 3-8) after blunt injury, excluding those who were missing medical records. Detailed descriptions of injuries were collected, then manually coded into AIS-1998 and AIS-2005 by the same Certified AIS Specialist. Compared to AIS-1998, AIS-2005 coded the same injuries with lower severity scores [p<0.01] and with decreased mean and maximum AIS-Head scores [p<0.01]. Of the types of traumatic brain injuries, most of the changes occurred among cerebellar and cerebral injuries. Traumatic hypoxic brain injury secondary to systemic dysfunction was captured by AIS-2005 but not by AIS-1998. However, AIS-2005 captured fewer loss of consciousness cases due to changes in criteria for coding concussive injury. In conclusion, changes from AIS-1998 to AIS-2005 result in significant differences in severity scores and types of injuries captured. This may complicate future TBI research by precluding direct comparison to datasets using AIS-1998. TBIs should be coded into the same AIS-version for comparison or evaluation of trends, and specify which AIS-version is used.

Author List

Carroll CP, Cochran JA, Price JP, Guse CE, Wang MC

Author

Marjorie Wang MD Clinical Transformation Officer, Professor in the Neurosurgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Abbreviated Injury Scale
Brain Injuries
Glasgow Coma Scale
Humans
Injury Severity Score
Religious Missions
Trauma Centers