构建基于国际疾病分类编码编制简易创伤评分方法评估的颌面部损伤与修复评分模型

A scoring model of maxillofacial injuries and repair evaluated by a simple traum a scoring method based on the codes of International Classification of Diseases

目的:探讨建立基于国际疾病分类编码的简易创伤评分方法的可行性,及颌面部损伤患者评分模型的结构框架。方法:第四军医大学附属口腔医院颌面外科1998-05/2002-04收治颌面部创伤患者644例。应用国际疾病分类编码与简明损伤定级分值转换表将患者的国际疾病分类编码转换为简明损伤定级分值并计算其新创伤严重度评分分值,通过多元线性回归分析,筛选除国际疾病分类-新创伤严重度评分分值外的其他影响创伤严重度的有关因素,建立预测专家评分新创伤严重度评分分值的数学模型。结果:644例患者数据均进入结果分析。①按照选出的包括国际疾病分类-新创伤严重度评分在内的3个变量和4个交互效应项进入专家新创伤严重度评分值预测模型,获得了模型的基本参数。②模型的检验结果显示,预测所得的新创伤严重度评分分值在一定程度上反映了专家评分的新创伤严重度评分分值,两者相关系数为r=0.3922,P<0.0001。结论:初步得出了颌面损伤患者简易评分模型的结构框架,以国际疾病分类编码为基础的简易创伤评分方法在颌面损伤患者的创伤评分方面具有较好的效果。

AIM:To probe into the feasibility constructing a simple trauma scoring method based on codes of International Classification of Diseases(ICD) and investigate the structural frame of the model for trauma scoring of patients with maxillofa cial injuries. METHODS:Totally 644 patients with maxillofacial injuries were selected from t he Stomatological Hospital,Fourth Military Medical University from May 1998 to A pril 2002.By using the conversion table of ICD codes and Abbreviated Injury Scal e(AIS) values,the codes of ICD in patients were conversed into AIS values(ICD- NISS),and then the severity values of ICD- NISS were calculated in each patient .Factors other than ICD- NISS affecting the evaluation of injury severity were screened out and predictive model for NISS values based on AIS values was worked out by professional raters using multivariate linear regression. RESULTS:The data in all the 644 patients were used for the result analysis.① Three variables and four interaction terms were entered the predicting model of trauma severity scores based on the selected ICD- NISS,and its basic parameter s were worked out.② Validation result showed that the predicted trauma severity scores were consistent with the NISS scores based on AIS values worked out by p rofessional raters to some extent with a linear correlation coefficient of 0.392 2(P CONCLUSION:A primary scheme of simple trauma scoring method based on ICD code s is obtained and it is effective in evaluating injury severity for patients wit h maxillofacial injuries.