• Helena Van Deynse, Wilfried Cools, Bart Depreitere, Ives Hubloue, Carl Ilunga Kazadi, Eva Kimpe, Maarten Moens, Karen Pien, Griet Van Belleghem, and Koen Putman.
• Interuniversity Centre for Health Economics Research, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: helena.van.deynse@vub.be.
• Injury. 2022 Jan 1; 53 (1): 11-20.

BackgroundRoutinely collected health data (RCHD) offers many opportunities for traumatic brain injury (TBI) research, in which injury severity is an important factor.ObjectiveThe use of clinical injury severity indices in a context of RCHD is explored, as are alternative measures created for this specific purpose. To identify useful scales for full body injury severity and TBI severity this study focuses on their performance in predicting these currently used indices, while accounting for age and comorbidities.DataThis study utilized an extensive population-based RCHD dataset consisting of all patients with TBI admitted to any Belgian hospital in 2016.MethodsFull body injury severity is scored based on the (New) Injury Severity Score ((N)ISS) and the ICD-based Injury Severity Score (ICISS). For TBI specifically, the Abbreviated Injury Scale (AIS) Head, Loss of Consciousness and the ICD-based Injury Severity Score for TBI injuries (ICISS) were used in the analysis. These scales were used to predict three outcome variables strongly related to injury severity: in-hospital death, admission to intensive care and length of hospital stay. For the prediction logistic regressions of the different injury severity scales and TBI severity indices were used, and error rates and the area under the receiver operating curve were evaluated visually.ResultsIn general, the ICISS had the best predictive performance (error rate between 0.06 and 0.23; AUC between 0.82 [0.81;0.83] and 0.86 [0.85;0.86]). A clearly increasing error rate can be noticed with advancing age and accumulating comorbidity.ConclusionBoth for full body injury severity and TBI severity, the ICISS tends to outperform other scales. It is therefore the preferred scale for use in research on TBI in the context of RCHD. In their current form, the severity scales are not suitable for use in older populations.Copyright © 2021. Published by Elsevier Ltd.

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