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Gaps in injury statistics: multiple injury profiles reveal them and provide a comprehensive account

Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel

Correspondence to:
Dr L Aharonson-Daniel
Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621 Israel; limorad{at}gertner.health.gov.il

ABSTRACT
Objective: To demonstrate the benefit of using multiple injury profiles (MIP) as an alternative to "primary diagnosis," for the presentation and analysis of multiple injuries in populations.

Methods: Retrospective analysis of national trauma registry data in Israel between 1 January 1998 and 31 December 2002. Multiple diagnoses per patient were recorded. A primary diagnosis was selected for each patient and data were presented twice: first by selecting a primary diagnosis and then using multiple injury profiles.

Results: 23 909 transport casualties were included. Findings show that MIP enable the identification of all patients with a specific injury, even where secondary. The proportion of additional injuries recorded when using MIP ranged from 12% in head injuries to 270% for facial injuries.

Based on the primary diagnosis patients with head, chest, and abdominal injuries had a 5–6% inpatient death rate each. Multiple injury profiles of the same population reveal that an isolated head injury has a 3% inpatient death rate, isolated chest and isolated abdomen have a 1% inpatient death rate, while combined head and chest casualties have a 21% inpatient death rate.

Conclusions: Multiple injury profiles are a new approach that enables presenting an improved picture of injury in a population.

Abbreviations: AIS, Abbreviated Injury Scale; ICU, intensive care unit; ISS, Injury Severity Score; MIP, multiple injury profiles

Keywords: multiple injury profile; primary injury; road crashes; transport