Citation

Tepas JJ, Crooms CB, Mollitt DL, String DL, Ramenofsky ML, Kitchens L, DiScala C. Proc. Assoc. Adv. Automot. Med. Annu. Conf. 1989; 33: 183-190.

Copyright

(Copyright © 1989, Association for the Advancement of Automotive Medicine)

DOI

unavailable

PMID

unavailable

Abstract

The inter-rater reliability of the injury severity score (ISS) and abbreviated injury scale (AIS) was evaluated by comparing codes entered in four pediatric trauma registries to those reassigned by an independent AIS coder. The 200 cases analyzed demonstrated an incidence of ISS agreement of 37% with a mean difference of 4.6 points ± 10.1. 876 diagnoses were also compared and documented an incidence of agreement of 83.1%. 12.4% of AIS codes were downgraded, while only 4.5% were upgraded in severity. The abdominal region demonstrated the highest degree of inconsistency (40%), followed by thoracic (30%), head and neck (26%), facial (17%), external (16%), and extremity/spine (15%) regions. This study suggests a low inter-rater reliability in the determination of the AIS for the pediatric population. The variances detected in AIS are magnified in calculation of the ISS, potentially undermining accurate outcome assessment.