A Preliminary Application of an Emergency Department-based Indepth Injury Surveillance System

ABSTRACT

PURPOSE: We tried to apply an Emergency-Departmentbased In-depth Injury Surveillance System designed on the basis of the International Classification of External Causes of Injuries (ICECI). METHODS: We registered prospectively all victims presenting with an injury from August 2004 to February 2005 at a local emergency center with 530 inpatient beds and 24 emergency beds. We evaluated the distribution and the proportion by injury-related factors and compared the severity by using the New Injury Severity Score (NISS), the Revised Trauma Score (RTS), the International Classification of Disease-10-based Injury Severity Score (ICISS). RESULTS: The total number of cases was 2,994 and 58.4% of those involved male. Accidental injuries were much greater in number (88.2%) than intentional injuries (10.7%). By mechanism, falls, motor vehicle accidents, piercing/cutting/biting, burns, poisoning/chemical, and other blunt injuries accounted for 28.3%, 14.0%, 13.8%, 3.9%, 2.8%, and 21.5%, respectively, of all injuries. The most common activity was unpaid work (27.3%) and the most common place was a home/residence or institute (44.1%). By severity based on the NISS, mild (below 8 points), moderate (9 to 24 points), and severe (above 25 points) injuries accounted for 89.6%, 9.6%, and 0.8%, respectively, of all injuries. The ICISS and the NISS showed a strongly negative correlation (correlation coefficient= -0.656, p<0.001), and the ICISS and the RTS showed a strongly positive correlation (correlation coefficient = 0.518, p<0.001). CONCLUSION: The In-depth EDISS based on the ICECI was a useful tool for the surveillance of injury-related factors and was a feasible method for measuring and comparing injury severity.