The Abbreviated Injury Scale and Injury Severity Score

TLDR

The Abbreviated Injury Scale (AIS) is widely used to rate trauma severity, but reliability concerns must be addressed. This article reports a study designed to resolve AIS reliability issues. Fifteen raters of varying qualifications coded AIS injuries for 375 trauma patients from four Baltimore hospitals. Physicians and nurses were more reliable than EMTs or nonclinical technicians, while a well‑trained research assistant could match physician reliability when chart information was sufficient; AIS reliability was also higher for blunt than penetrating injuries.

Abstract

Given the wide usage and proven value of the Abbreviated Injury Scale (AIS) in rating severity of trauma, it is essential that certain reliability issues concerning its application be resolved. This article describes a study designed to address these reliability issues. Each of 15 raters with varying qualifications was asked to identify AIS code injuries sustained by 375 trauma patients admitted to four Baltimore area hospitals. Results showed that as a group, physicians and nurses tend to be more reliable in their ratings than either emergency medical technicians (EMTs) or nonclinical technicians, although a research assistant who is well trained in AIS coding and is a diligent worker can use the AIS to code severity as reliably as the physicians when sufficient information is provided in the medical chart. Reliability of AIS scoring was somewhat higher for blunt (vehicular and nonvehicular) versus penetrating injuries.