Abstract
Objective
This study examined the correlation between the worst abbreviated injury scale 1990 (AIS) intracranial severity score and outcome following severe head injury.
Design
The initial CT scans of 109 severly head injury patients were examined by a neuroradiologist and classified according to the worst applicable intracranial severity code from the AIS. This score was then correlated with the glasgow outcome scale (GOS) at 6 months. For comparison, the GOS was also correlated with the diffuse injury scale (DIS) described by L.F. Marshall et al. [5], the worst post-resuscitation Glasgow coma score (GCS) in the first 24 h, and the head injury outcome prediction tree described by Choi et al. [1].
Results
Our results show Spearman rank correlation coefficients of 0.58 (p<0.001), 0.47 (p<0.001), 0.45 (p<0.001), and 0.31 (p<0.01) for the correlation between the AIS, prediction tree, DIS, and GCS respectively and the GOS. Independent outcome (i.e. GOS good or moderate) was strongly predicted by an AIS of 3 or less (positive predictive value 95%, specificity 98%, sensitivity 40%, likelihood ratio 25∶1). Death or vegetative survival was less strongly predicted in patients with an AIS of 5 (positive predictive value 71%, specificity 75%, sensitivity 67%, likelihood ratio 2.7∶1).
Conclusion
The AIS, based on initial CT scan, provides useful prognostic information in patients with severe head injury.
References
Choi SC, Muizelaar JP, Barnes TY et al (1991) Prediction tree for severely head injured patients. J Neurosurg 75:251–255
Choi SC, Narayan R, Anderson R et al (1988) Enhanced specificity of prognosis in severe head injury. J Neurosurg 69:381–385
Choi SC, Ward JD, Becker DP (1983) Chart for outcome prediction in severe head injury. J Neurosurg 59:294–297
Clifton G, Grossman R, Mekela M et al (1980) Neurological course and correlated computerised tomography findings after severe closed head injury. J Neurosurg 52:611–624
Marshall L, Eisenberg H, Jane J et al (1991) A new classification of head injury based on computerised tomography. J Neurosurg 75:S14-S20
Narayan R, Greenberg R, Miller D et al (1981) Improved confidence of outcome prediction in severe head injury. J Neurosurg 54:751–762
American Association for Automotive Medicine (1990) The abbreviated injury scale — 1990 revision. Des Plaines, Illinois
Baker S, O'Neill B, Haddon W et al (1974) The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 14:187–196
Champion H, Sacco W, Hunt T (1983) Trauma severity scoring to predict mortality. World J Surg 7:4–11
Copes W, Champion H, Sacco W et al (1988) The injury severity score revisited. J Trauma 28:69–77
Gennarelli TA (1980) Analysis of head injury severity by AIS-80. Proceedings of American Association for Automotive Medicine, Rochester, NY
Genarelli TA, Champion HR, Sacco WJ et al (1988) Mortality of patients with head injury and extracranial injury treated in trauma centres. J Trauma 29:1193–1201
Jennet B, Bond M (1975) Assessment of outcome after severe brain damage: a practical scale. Lancet I:480–484
Sackett DL, Haynes RB, Guyatt GH, Tugwell P (1985) The interpretation of diagnostic data. In: Clinical epidemiology: a basic science for clinical medicine. Little, Brown & Co, Boston, pp 119–139
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Walder, A.D., Yeoman, P.M. & Turnbull, A. The abbreviated injury scale as a predictor of outcome of severe head injury. Intensive Care Med 21, 606–609 (1995). https://doi.org/10.1007/BF01700170
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01700170