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A New Method to Classify Injury Severity by Diagnosis: Validation Using Workers' Compensation and Trauma Registry
Jeanne M Sears1,2, Stephen M Bowman3,4, Mary Rotert5
1Department of Health Services, School of Public Health, University of Washington, Box 357660, Seattle, WA, 98195, USA. jeannes@uw.edu.
Journal of Occupational Rehabilitation
|April 23, 2015
Summary
A new severe injury indicator using diagnosis codes effectively predicts work disability and medical costs. This method offers a simpler, transparent alternative to Abbreviated Injury Scale (AIS) for assessing occupational injury severity.
Area of Science:
- Occupational health and safety
- Trauma registry analysis
- Injury surveillance systems
Background:
- Acute work-related trauma is a significant cause of death and disability in the U.S.
- Current methods for estimating injury severity have limitations.
- A severe injury indicator using diagnosis codes was developed for surveillance.
Purpose of the Study:
- To evaluate the severe injury indicator's ability to predict work disability and medical costs.
- To determine if the indicator can substitute for Abbreviated Injury Scale (AIS)-based severity estimation from workers' compensation (WC) data.
- To assess concordance between indicators derived from the Washington State Trauma Registry (WTR) and WC data.
Main Methods:
- Linked WC claims (1998-2008) with WTR records for injured Washington State workers.
- Employed competing risks survival analysis for work disability outcomes and linear regression for medical costs.
- Compared information content of the severe injury indicator and AIS-based measures using AIC and R-squared.
Main Results:
- 5% of 208,522 WC claims were classified as severe.
- High agreement (kappa = 0.75) between WC-based and WTR-based severe injury indicators.
- The indicator significantly predicted hospitalization, time loss, permanent disability, and medical costs, with information content similar to some AIS measures.
Conclusions:
- Severe traumatic injuries can be directly identified using available diagnosis codes.
- This diagnosis code-based method offers a straightforward and transparent alternative to AIS-based injury severity estimation.
