ArticleBMC emergency medicine2019
Injury coding in a national trauma registry: a one-year validation audit in a level 1 trauma centre.
Article in BMC emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 17 citations in OpenAlex.
- Early discharges in severely injured patients by ISS score: exploring injury patterns and coding practices.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- The potential impact of changing the Norwegian trauma Registry inclusion criteria for patients not admitted with trauma team activation: Identifying patient groups to be excluded and considering potential risks.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Advancing trauma scoring through large language models: automated estimation of injury severity.BMC emergency medicine · 2026Article
- Validity of diagnostic codes used to ascertain maternal injuries during pregnancy.American journal of epidemiology · 2025Article
- Moderate and severe traumatic brain injury: abbreviated injury scale scoring and coding of traumatic axonal injury from early MRI.BMC emergency medicine · 2025Article
- Coding traumatic brain injury with the abbreviated injury scale following a standardised radiologic template will improve classification of trauma populations.European radiology · 2025Article
- Injury Severity Scoring in the Resuscitation Room-Is Preliminary Injury Severity Score Accurate?Acta anaesthesiologica Scandinavica · 2025Article
- Excellent agreement of Norwegian trauma registry data compared to corresponding data in electronic patient records.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
- Validation of the Swedish Trauma Registry (SweTrau).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Trauma Registry Data as a Policy-Making Tool: A Systematic Review on the Research Dimensions.Bulletin of emergency and trauma · 2022Review
- Accuracy and reliability of injury coding in the national Dutch Trauma Registry.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2021Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHospitals must improve patient safety and quality continuously. Clinical quality registries can drive such improvement. Trauma registries code injuries according to the Abbreviated Injury Scale (AIS) and benchmark outcomes based on the Injury Severity Score (ISS) and New ISS (NISS). The primary aim of this study was to validate the injury codes and severities registered in a national trauma registry. Secondarily, we aimed to examine causes for missing and discordant codes, to guide improvement of registry data quality.
methodsWe conducted an audit and established an expert coder group injury reference standard for patients met with trauma team activation in 2015 in a Level 1 trauma centre. Injuries were coded according to the AIS. The audit included review of all data in the electronic health records (EHR), and new interpretation of all images in the picture archiving system. Validated injury codes were compared with the codes registered in the registry. The expert coder group's interpretations of reasons for discrepancies were categorised and registered. Inter-rater agreement between registry data and the reference standard was tested with Bland-Altman analysis.
resultsWe validated injury data from 144 patients (male sex 79.2%) with median age 31 (inter quartile range 19-49) years. The total number of registered AIS codes was 582 in the registry and 766 in the reference standard. All injuries were concordantly coded in 62 (43.1%) patients. Most non-registered codes (n = 166 in 71 (49.3%) patients) were AIS 1, and information in the EHR overlooked by registrars was the dominating cause. Discordant coding of head injuries and extremity fractures were the most common causes for 157 discordant AIS codes in 74 (51.4%) patients. Median ISS (9) and NISS (12) for the total population did not differ between the registry and the reference standard.
conclusionsConcordance between the codes registered in the trauma registry and the reference standard was moderate, influencing individual patients' injury codes validity and ISS/NISS reliability. Nevertheless, aggregated median group ISS/NISS reliability was acceptable.
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