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Invited Critique
April 20, 2009

Expert Consensus vs Empirical Estimation of Injury Severity—Invited Critique

Arch Surg. 2009;144(4):332. doi:10.1001/archsurg.2008.581

Glance et al have produced an important article that outlines a new and useful trauma quality method, the T-MPM, that compares favorably with the ISS in terms of predicting mortality. The T-MPM is based on the ICD-CM-9 diagnosis codes, which are used for the hospital administrative data set as part of the hospital billing process. Conversely, the ISS, currently used by many trauma centers, is derived from the AIS, requiring a more labor-intensive coding and trauma database process. The authors further demonstrated that the ISS and T-MPM could be improved (augmented ISS and T-MPM) by inclusion of 3 patient-specific factors to the calculation (age, sex, and the motor component of the GCS), resulting in almost identical conclusions regarding trauma mortality.

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