Does a given abbreviated injury scale value in different body regions contribute to the same risks of in-hospital mortality and ICU admission in trauma patients?

Armin Khavandegar; Seyed Amir  Miratashi Yazdi; Payman  Salamati; Mohammadreza  Zafarghandi; Vafa  Rahimi-Movaghar; Esmaeil  Fakharian; Seyed Houssein Saeed-Banadaky; Vahid  Hoseinpour; Farideh  Sadeghian; Mehdi Nasr  Isfahani; Vahid Rahmanian; Amir  Ghadiphasha; Sobhan  Pourmasjedi; Rahim Aali; Mohamad Kogani; Homayoun  Sadeghi-Bazargani; Reza Farahmand Rad; Seyed Mohammad  Piri; Sara  Mirzamohamadi; Mahgol Sadat  Hassan Zadeh Tabatabaei; Khatereh Naghdi; Vali  Baigi

doi:10.18502/fem.v8i2.15462

Armin Khavandegar Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Seyed Amir Miratashi Yazdi Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Payman Salamati Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Mohammadreza Zafarghandi Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Vafa Rahimi-Movaghar Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Esmaeil Fakharian Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran.
Seyed Houssein Saeed-Banadaky Trauma Research Center, Rahnemoon Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Vahid Hoseinpour Department of Emergency Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Farideh Sadeghian Center for Health-related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences Shahroud, Iran.
Mehdi Nasr Isfahani Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Vahid Rahmanian Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran.
Amir Ghadiphasha Department of Pediatrics, Shahid Modarres Hospital, Saveh University of Medical Sciences, Tehran, Iran.
Sobhan Pourmasjedi Department of Environmental Health, School of Health Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran.
Rahim Aali Department of Environmental Health, School of Health Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran.
Mohamad Kogani Research Center for Environmental Contaminants (RCEC), Abadan University of Medical Sciences, Abadan, Iran.
Homayoun Sadeghi-Bazargani Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Reza Farahmand Rad Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Seyed Mohammad Piri Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Sara Mirzamohamadi Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Mahgol Sadat Hassan Zadeh Tabatabaei Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Khatereh Naghdi Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
Vali Baigi Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.

DOI: https://doi.org/10.18502/fem.v8i2.15462

Keywords: Abbreviated Injury Scale (AIS); Injury Severity Score (ISS); Mortality; Trauma; Wound and Injury; Scoring System

Abstract

Objective: We aimed to investigate the hypothesis that identical abbreviated injury scale (AIS) scores may lead to varying risks of in-hospital mortality and admission to the intensive care unit (ICU) depending on the specific body region affected.

Methods: This study focused on hospitalized trauma patients with moderate to serious injuries (AIS=2, 3). The final sample was stratified based on the injured body regions. To determine the impact of these injuries on mortality and ICU admission, we conducted binary logistic regression after adjusting for confounding factors.

Results: Overall, 16,040 trauma patients with moderate injury (AIS=2) and 1,338 trauma patients with serious injury (AIS=3) were included in this study. When comparing outcome of trauma patients in different body region, there was no significant difference in the odds of two main outcomes in various injury sites, except for extremities (P values>0.05). When the AIS=2 patients were controlled for confounding factors, the adjusted odds of mortality were significantly higher for head, face, and neck injuries, as well as spine/back, thoracic, and abdominal injuries, compared to extremity injuries (adjusted odds ratio (aOR)s=9.81,8.78, 8.11, and 3.96, respectively; P-values<0.05). Among those with AIS=3, the odds of mortality were significantly greater for abdominal (aOR=7.05, P-value=0.009) and head, face, and neck injuries (aOR=2.73, P-value=0.001) than for extremity injuries.

Conclusion: Injuries with the same AIS (=2, 3) value almost indistinguishably confer the same mortality risk and ICU admission, except for extremities. The unique AIS value assigned to various body sites almost consistently indicate the same likelihood of negative outcomes.