 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Stephen Strotmeyer, MPH, University of Pittsburgh, Center for Injury Research and Control (CIRCL), 200 Lothrop Street, Suite B400-PUH, Pittsburgh, PA 15213, 412-648-3904, strotmeyers@msx.upmc.edu and Harold B. Weiss, MPH, PhD, Center for Injury Research and Control, University of Pittsburgh, 200 Lothrop St., Suite B400, Pittsburgh, PA 15213.
Introduction: Previous studies encouraged trauma centers°¯ injury prevention programs to extend beyond global data sources to set priorities. Thorough analysis of institutional data reflects the specific needs of the local population. Assignment of a new injury prevention priority score (IPPS) demonstrated better targeted initiatives. Objective: To compare the IPPS using the mean Injury Severity Score (ISS) versus the median ISS. As the median is less sensitive to extreme scores than the mean, this may potentially improve the measure within asymmetrical or highly skewed distributions. Study Population: Pediatric patients discharged from a regional resource level I pediatric trauma center (n=1306) during the 2000 data year (1/1/2000-12/31/2000). Patients were °Ü16 years and grouped by ICD-9-CM E-code. Methods: The IPPS for the leading ten mechanisms of injury was calculated as follows: IPPS = (# cases)(mean ISS). The modified IPPS (MIPPS) was calculated as follows: IPPS = (# cases)(median ISS). Results: Ranking based on IPPS versus the MIPPS shows the two calculations produced different injury prevention priorities, notably, the shifts in poisonings and the "other, specified and classifiable" types. Conclusion: While The IPPS is a simple tool that uses data available in trauma registries to rank injury causes according to both the number of cases and their severity, it uses the arithmetic mean, and is highly prone to skewness. As hospital discharge data is generally asymmetric, we recommend a simple modification to the IPPS by using the median ISS to account for statistical outliers.
Learning Objectives:
Keywords: Injury Prevention, Methodology
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.