Deriving injury severity from crash trauma data: RAPEX HARM from AIS 2015 coded injuries

Area of Science:

• Public Health
• Trauma Research
• Risk Assessment

Background:

• The EU's Safety Gate Rapid Alert System (RAPEX) requires Hazard and Risk Assessment Methodology (HARM) evaluations for dangerous non-food products.
• HARM assessments consider acute injury severity and long-term consequences (LTC).
• Current methods struggle to directly utilize Abbreviated Injury Scale (AIS) 2015 trauma data for HARM evaluations.

Purpose of the Study:

• To develop a post-processing method for direct computation of RAPEX HARM assessments from AIS 2015-coded trauma data.
• To enable patient-level HARM evaluations using existing trauma databases.

Main Methods:

• Analyzed real-world crash data from the German In-depth Accident Study (GIDAS) database (1999-2024).
• Aggregated 6-digit AIS unique identifiers (AIS-IDs) to address coding variability.
• Summarized individual injury severities using the three most severe injuries (triples) for person-level analysis.
• Assigned HARM Level (1-4) based on the most severe outcome, considering both AIS Code (AIS-CD) and predicted Functional Capacity Index (pFCI).

Main Results:

• The AIS Code (AIS-CD) was the primary determinant for lower HARM scores.
• Long-term consequences (LTC) metric (pFCI) became more influential at higher HARM severities.
• At HARM 4, AIS-CD dominated in 53% of cases, pFCI in 16%, and both equally in 31%.

Conclusions:

• A novel post-processing method enables RAPEX HARM value assignment using AIS 2015 data.
• The method integrates both acute threat to life (AIS-CD) and long-term consequences (pFCI) information.
• This facilitates direct RAPEX evaluations of crash and trauma databases.