Injury prevention priority score: A new method for trauma centers to prioritize injury prevention initiatives¹

Abstract

Background 

Trauma centers are expected to develop injury prevention programs that address needs of the local population. A relatively simple, objective, and quantitative method is needed for prioritizing local injury prevention initiatives based on both injury frequency and severity.

Study design 

Pediatric trauma patients (16 years or younger; n= 7,958) admitted to two Level I regional trauma centers (Johns Hopkins Children Center and Westchester Medical Center) from 1993 to 1999 were grouped by injury causal mechanism according to ICD-9 external cause codes. An Injury Prevention Priority Score (IPPS), balancing the influences of severity (based on the Injury Severity Score) and frequency, was calculated for each mechanism and mechanisms were ranked accordingly.

Results 

IPPS-based rank lists differed across centers. The highest ranked mechanism of injury among children presenting to Johns Hopkins Children Center was “pedestrian struck by motor vehicle,” and at Westchester Medical Center it was “motor vehicle crash.” Different age groups also had specific injury prevention priorities, eg, “child abuse” was ranked second highest among infants at both centers. IPPS was found to be stable (r = 0.82 to 0.93, p < 0.05) across alternate measures of injury severity.

Conclusions 

IPPS is a relatively simple and objective tool that uses data available in trauma center registries to rank injury causes according to both frequency and severity. Differences between two centers and across age groups suggest IPPS may be useful in tailoring injury prevention programs to local population needs.