Validation of the International Classification of Diseases l0th Edition Based Injury Severity Score(ICISS) - Agreement of ICISS Survival Probability with Professional Judgment on Preventable Death -

외상환자 중증도 평가도구의 타당도 평가 - ICISS 사망확률과 전문가의 예방가능한 사망에 대한 판단간의 일치도 -

  • Kim, Yoon (Department of Social Medicine, School of Medicine, Sungkyunkwan University) ;
  • Ah, Hyeong-Sik (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Lee, Young-Sung (Department of Health Policy and Management, College of Medicine, Chungbuk National University)
  • 김윤 (성균관대학교 의과대학 사회의학교실) ;
  • 안형식 (고려대학교 의과대학 예방의학교실) ;
  • 이영성 (충북대학교 의과대학 의료관리학교실)
  • Published : 2001.03.01

Abstract

The purpose of the present study was to assess the agreement of survival probability estimated by International Classification of Diseases l0th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with professional panel's judgment on preventable death. ICISS has a promise as an alternative to Trauma and Injury Severity Score(TRISS) which have served as a standard measure of trauma severity, but requires more validation studies. Furthermore as original version of ICISS was based ICD-9CM, it is necessary to test its performance employing ICD-10 which has been used in Korea and is expected to replace ICD-9 in many countries sooner or later. Methods : For 1997 and 1998 131 trauma deaths and 1,785 blunt trauma inpatients from 6 emergency medical centers were randomly sampled and reviewed. Trauma deaths were reviewed by professional panels with hospital records and survival probability of trauma inpatients was assessed using ICD-10 based ICISS. For trauma mortality degree of agreement between ICISS survival probability with judgment of professional panel on preventable death was assessed and correlation between W-score and preventable death rate by each emergency medical center was assessed. Results : Overall agreement rate of ICISS survival probability with preventable death judged by professional panel was 66.4%(kappa statistic 0.36). Spearman's correlation coefficient between W-score and preventable death rate by each emergency medical center was -0.77(p=0.07) and Pearson's correlation coefficient between them was -0.90(p=0.01). Conclusions : The agreement rate of ICD-10 based ICISS survival probability with of professional panel's judgment on preventable death was similar to TRISS. The W-scores of emergency medical centers derived from ICD-10 based ICISS were highly correlated with preventable death rates of them with marginal statistical significance.

Keywords

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