The International Classification of Disease Critical Care Severity Score Demonstrates that Pediatric Burden of Injury is Similar to that of Adults: Validation Using the National Trauma Databank
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In brief
In brief
Validation study using 5.87 million trauma patients demonstrating that the ICD Critical Care Severity Score (ICASS) accurately predicts critical care resource utilization and reveals pediatric injury burden comparable to adults. This resource-based scoring system may better characterize trauma severity than traditional mortality-based measures like ICISS.
Written by the GCMD Library team from the article.
Background/Purpose
Resource-based severity of injury (SOI) measures, such as the International Classification of Disease (ICD) Critical Care Severity Score (ICASS), may characterize traumatic burden better than standard mortality-based measures. The purpose of this study was to validate the ICASS in a representative national-level trauma cohort and compare SOI measures between children and adults.
Methods
The National Trauma Databank was used to derive (2008-12) and validate (2013-15) ICASS and ICD Injury Severity Scores (ICISS, standard mortality-based SOI measure). SOI metrics and outcomes were compared between pediatric, adult, and elderly age groups. Logistic regression modeling evaluated predictors of critical care resource utilization.
Results
Derivation and validation cohorts consisted of 3.90 and 1.97 million patients, respectively. ICASS strongly predicted actual critical care utilization (OR 1.04, 95% CI 1.04-1.04, p