TY - JOUR
T1 - Considering the patient's perspective in the injury severity score
AU - Geiger, Angie A.
AU - Deroon-Cassini, Terri
AU - Brasel, Karen J.
N1 - Funding Information:
The statistical analysis was performed by Jessica Pruszynski, Ph.D. and Dan Eastwood, M.S. of the Medical College of Wisconsin's Biostatistics Consulting Service. This service is supported by funds from the Institute for Health and Society, Division of Biostatistics , and by grant 1UL1RR031973 from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health . The authors thank Linda Meurer, M.D., M.P.H. and the National Institute on Aging (NIA) T35 Research Training Grant Summer 2010. The authors also thank Bonnie Krajcik, Trauma Registrar, Colleen Trevino, R.N. A.C.N.P., and Edmund Duthie, M.D.
PY - 2011/9
Y1 - 2011/9
N2 - Background: The injury severity score (ISS) assesses anatomical threat to life, but does not correlate with severity perceived by the patient. The purpose of this study was to assess how and why patients assign perceived injury severity. Methods: One hundred twenty consecutive patients were asked "Would you say your injury is mild, moderate, severe or very severe?" and "Why do you rate your injury that way?" Explanations were categorized and compared by age, perceived injury severity, and injury mechanism. Categories were pain, injury assessment, injury description, and others. The age groups used were <55 and ≥55 y old. The data were analyzed with Wilcoxon rank sum, Spearman's correlation coefficient, and Mantel-Haenszel tests. Results: The ISS was not significantly correlated with perceived injury severity scores (r2 = 0.177, P = 0.0535, Spearman's correlation), and most patients reported a higher injury severity. Patients with penetrating injuries significantly overestimated their injury severity (P = 0.014, Wilcoxon rank sum). Patients with mild and moderate injuries gave more assessment explanations, whereas patients with severe or very severe injuries gave more description explanations (P = 0.0220, Mantel-Haenszel). Conclusions: Patients based perceived severity on their injuries, but it did not correlate with ISS, likely because ISS considers injuries graded events, while the patient considers them all or none events. Assessment responses suggested relief, whereas description responses indicated more distress. It is important to ask patients about their injury severity to help them better cope with their experience, which will likely improve quality of life outcomes.
AB - Background: The injury severity score (ISS) assesses anatomical threat to life, but does not correlate with severity perceived by the patient. The purpose of this study was to assess how and why patients assign perceived injury severity. Methods: One hundred twenty consecutive patients were asked "Would you say your injury is mild, moderate, severe or very severe?" and "Why do you rate your injury that way?" Explanations were categorized and compared by age, perceived injury severity, and injury mechanism. Categories were pain, injury assessment, injury description, and others. The age groups used were <55 and ≥55 y old. The data were analyzed with Wilcoxon rank sum, Spearman's correlation coefficient, and Mantel-Haenszel tests. Results: The ISS was not significantly correlated with perceived injury severity scores (r2 = 0.177, P = 0.0535, Spearman's correlation), and most patients reported a higher injury severity. Patients with penetrating injuries significantly overestimated their injury severity (P = 0.014, Wilcoxon rank sum). Patients with mild and moderate injuries gave more assessment explanations, whereas patients with severe or very severe injuries gave more description explanations (P = 0.0220, Mantel-Haenszel). Conclusions: Patients based perceived severity on their injuries, but it did not correlate with ISS, likely because ISS considers injuries graded events, while the patient considers them all or none events. Assessment responses suggested relief, whereas description responses indicated more distress. It is important to ask patients about their injury severity to help them better cope with their experience, which will likely improve quality of life outcomes.
KW - injury severity
KW - patient perception
KW - quality of life
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U2 - 10.1016/j.jss.2011.03.026
DO - 10.1016/j.jss.2011.03.026
M3 - Article
C2 - 21550062
AN - SCOPUS:80051552596
SN - 0022-4804
VL - 170
SP - 133
EP - 138
JO - Journal of Surgical Research
JF - Journal of Surgical Research
IS - 1
ER -