Predictive capability of the injury severity score versus the new injury severity score in the categorization of the severity of trauma patients: a cross-sectional observational study.

PURPOSE: The AIS scale is a measurement tool for single injuries. The ISS is considered the gold standard for determining the severity of injured patients, and the NISS was developed to improve the ISS with respect to loss of information, as well as to facilitate its calculation. The aim of this study was to analyse what injury severity measure, calculated according to the Abbreviated Injury Scale (AIS), 1998 and 2005 (update 2008) versions, performs better with mortality, cost and hospital length of stay healthcare indicators. METHODS: This cross-sectional observational study was carried out between February 1st 2012 and February 1st 2013. Inclusion criteria were injured patients due to external causes admitted to trauma service through the emergency department. Manual coding of all injuries was performed and ISS and NISS scores were calculated for both versions of the AIS scale. Severity was then compared to mortality (in-hospital and at 30 days), healthcare cost, and length of hospital stay. RESULTS: The index with the best predictive capability for in-hospital mortality was NISS 05 (AUC = 0.811). There was a significant increase in hospital stay and healthcare cost in the most severe patients in all indexes, except for ISS 05. CONCLUSIONS: NISS is found to be an index with higher predictive capability for in-hospital mortality and correlates better to length of hospital stay and healthcare cost.

Comparison of injury severity scores (ISS) obtained by manual coding versus "Two-step conversion" from ICD-9-CM.

BACKGROUND: The International Classification of Diseases (ICD) is the standard diagnostic tool for classifying and coding diseases and injuries. The Abbreviated Injury Scale (AIS) is the most widely used injury severity scoring system. Although manual coding is considered the gold standard, it is sometimes unavailable or impractical. There have been many prior attempts to develop programs for the automated conversion of ICD rubrics into AIS codes. OBJECTIVE: To convert ICD, Ninth Revision, Clinical Modification (ICD-9-CM) codes into AIS 2005 (update 2008) codes via a derived map using a two-step process and, subsequently, to compare Injury Severity Score (ISS) resulting from said conversion with manually coded ISS values. METHODS: A cross-sectional retrospective study was designed in which medical records at the Hospital Universitario Marqués de Valdecilla of Cantabria (HUMV) and the Complejo Hospitalario of Navarra (CHN), both in Spain, were reviewed. Coding of injuries using AIS 2005 (update 2008) version was done manually by a certified AIS specialist and ISS values were calculated. ICD-9-CM codes were automatically converted into ISS values by another certified AIS specialist in a two-step process. ISS scores obtained from manual coding were compared to those obtained through this conversion process. RESULTS: The comparison of obtained through conversion versus manual ISS resulted in 396 concordant pairs (70.2%); the analysis of values according to ISS categories (ISS<9, ISS 9-15, ISS 16-24, ISS>24) showed 493 concordant pairs (87.4%). Regarding the criterion of "major trauma" patient (i.e., ISS> 15), 538 matching pairs (95.2%) were obtained. The conversion process resulted in underestimation of ISS in 112 cases (19.9%) and conversion was not possible in 136 cases (19%) for different reasons. CONCLUSIONS: The process used in this study has proven to be a useful tool for selecting patients who meet the ISS>15 criterion for "major trauma". Further research is needed to improve the conversion process.

Classification of the severe trauma patient with the Abbreviated Injury Scale: degree of correlation between versions 98 and 2005 (2008 update). / Grado de correlación entre las versiones 98 y 2005 (actualización 2008) de la Abbreviated Injury Scale (AIS) en la categorización del paciente traumatológico grave.

OBJECTIVES: To explore differences in severity classifications according to 2 versions of the Abbreviated Injury Scale (AIS): version 2005 (the 2008 update) and the earlier version 98. To determine whether possible differences might have an impact on identifying severe trauma patients. MATERIAL AND METHODS: Descriptive study and cross-sectional analysis of a case series of patients admitted to two spanish hospitals with out-of-hospital injuries between February 2012 and February 2013. For each patient we calculated the Injury Severity Score (ISS), the New Injury Severity Score (NISS), and the AIS scores according to versions 98 and 2005. RESULTS: The sample included 699 cases. The mean Severity (SD) age of patients was 52.7 (29.2) years, and 388 (55.5%) were males. Version 98 of the AIS correlated more strongly with both the ISS (2.6%) and the NISS (2.9%). CONCLUSION: The 2008 update of the AIS (version 2005) classified fewer trauma patients than version 98 at the severity levels indicated by the ISS and NISS.

OBJETIVO: Estudiar si existen diferencias en la asignación de gravedad entre las versiones 98 y 2005 ­actualización 2008­ de la escala Abbreviated Injury Scale (AIS) y determinar si estas posibles diferencias podrían tener repercusión en la definición de paciente traumatológico grave. METODO: Estudio descriptivo de una serie de casos con análisis transversal que incluyó a pacientes ingresados por lesiones debidas a causas externas en dos hospitales españoles, llevado a cabo entre febrero de 2012 y febrero de 2013. Se calculó el Injury Severity Score (ISS) y el New Injury Severity Score (NISS) de cada uno de los casos con ambas versiones de la escala AIS. RESULTADOS: La muestra estuvo compuesta por 699 casos, con una edad media de 52,7 (DE 29,2) años, de los cuales 388 (55,5%) fueron varones. Se obtuvo una mayor clasificación de pacientes graves con la versión AIS 98, tanto para el ISS (2,6%) como el NISS (2,9%). CONCLUSIONES: La versión AIS 2005 ­actualización 2008­ clasifica un menor número de pacientes como graves en comparación con la versión AIS 98.

Grado de correlación entre las versiones 98 y 2005 (actualización 2008) de la Abbreviated Injury Scale (AIS) en la categorización del paciente traumatológico grave / Classification of the severe trauma patient with the Abbreviated Injury Scale: degree of correlation between versions 98 and 2005 (2008 update)

Objetivos. Estudiar si existen diferencias en la asignación de gravedad entre las versiones 98 y 2005 -actualización 2008- de la escala Abbreviated Injury Scale (AIS) y determinar si estas posibles diferencias podrían tener repercusión en la definición de paciente traumatológico grave. Método. Estudio descriptivo de una serie de casos con análisis transversal que incluyó a pacientes ingresados por lesiones debidas a causas externas en dos hospitales españoles, llevado a cabo entre febrero de 2012 y febrero de 2013. Se calculó el Injury Severity Score (ISS) y el New Injury Severity Score (NISS) de cada uno de los casos con ambas versiones de la escala AIS. Resultados. La muestra estuvo compuesta por 699 casos, con una edad media de 52,7 (DE 29,2) años, de los cuales 388 (55,5%) fueron varones. Se obtuvo una mayor clasificación de pacientes graves con la versión AIS 98, tanto para el ISS (2,6%) como el NISS (2,9%). Conclusiones. La versión AIS 2005 -actualización 2008- clasifica un menor número de pacientes como graves en comparación con la versión AIS 98 (AU)

Objectives. To explore differences in severity classifications according to 2 versions of the Abbreviated Injury Scale (AIS): version 2005 (the 2008 update) and the earlier version 98. To determine whether possible differences might have an impact on identifying severe trauma patients. Methods. Descriptive study and cross-sectional analysis of a case series of patients admitted to two Spanish hospitals with out-of-hospital injuries between February 2012 and February 2013. For each patient we calculated the Injury Severity Score (ISS), the New Injury Severity Score (NISS), and the AIS scores according to versions 98 and 2005. Results. The sample included 699 cases. The mean Severity (SD) age of patients was 52.7 (29.2) years, and 388 (55.5%) were males. Version 98 of the AIS correlated more strongly with both the ISS (2.6%) and the NISS (2.9%). Conclusion. The 2008 update of the AIS (version 2005) classified fewer trauma patients than version 98 at the severity levels indicated by the ISS and NISS (AU)

Aversiones y preferencias alimenticias de los estudiantes de Enfermería y Fisioterapia / Food aversions and preferences of Nursing and Physical Therapy students

Objetivo: describir las aversiones y preferencias alimenticias de los estudiantes de Enfermería y Fisioterapia en las Universidades de Cantabria, País Vasco y Extremadura. Método: se realizó un estudio transversal, analizando una muestra de 606 alumnos: 88 varones (14,5 %) y 518 mujeres(85,5 %), de 18 a 43 años de edad, matriculados en las Escuelas de Enfermería y Fisioterapia citadas, mediante el empleo de un cuestionario autoadministrado. Se diseñó una base de datos en Access de Microsoft® dotada de mecanismos que impedían la introducción de valores erróneos. Se analizaron los datos empleando el paquete estadístico R, versión 2.9.0. En todos los contrastes de hipótesis el nivel de significación se situó en el 0,05. Resultados: la pasta alimenticia, el jamón serrano y las patatas son los alimentos preferidos de los estudiantes, porotro lado, las verduras y hortalizas, las legumbres y el marisco constituyen las principales aversiones alimenticias. Las lentejas,la lechuga, la fresa, el agua y la pasta alimenticia en general fueron los alimentos más valorados dentro de sus respectivos grupos de alimentos y bebidas.Conclusión: los datos obtenidos son útiles para detectar hábitos alimentarios y observar las tendencias futuras sobrepreferencias alimenticias que, conjuntamente con otros parámetros,permitan caracterizar el comportamiento alimentario de los jóvenes universitarios (AU)

Objective: to describe the food aversions and preferences of Nursing and Physical Therapy students in the Universities of Cantabria, the Basque Country and Extremadura.Method: a cross-sectional study was performed, in which asample of 606 students was analysed: 88 males (14,5%) and 518 females (85,5%), aged 18 to 43 years, enrolled in the aforementioned Nursing and Physical Therapy Schools,completed a self-administered questionnaire. A database endowed with mechanisms that prevented the introduction of incorrect values was designed using Microsoft Access®. Data were analysed using the R statistical program, version 2.9.0. In all hypotheses contrasts, the significance level was 0,05.Results: dietary pasta, cured serrano ham and potatoes were the students’ favourite foods. On the other hand, vegetables,legumes and fish comprised the primary food aversions.Overall, lentils, lettuce, strawberries, water and dietarypasta were the most highly valued foods with in their corresponding food and drink groups.Conclusion: the data obtained are useful to detect eating habits and observe future trends of food preferences, which,together with other parameters, enable us to characterize the eating behaviour of university students (AU)

Conocimiento y cumplimiento de las medidas de bioseguridad y accidentes biológicos de los estudiantes de enfermería en las prácticas clínicas / Knowledge and adherence to bio-safety measures and biological accidents by nursing students during their clinical practice

Objetivo. Identificar el grado de conocimiento y aplicación de las medidas de bioseguridad en los estudiantes de Enfermería, así como conocer los tipos de accidentes biológicos durante sus prácticas clínicas. Método. Estudio descriptivo y transversal, realizado en los estudiantes de los tres cursos de Enfermería durante el mes de mayo de 2008. La información se recogió mediante un cuestionario anónimo de autocumplimentación, obteniendo una participación del 54%. Resultados. El 97% de los estudiantes manifiesta conocer las precauciones estándares y el 100% afirma que deben ser aplicadas a todos los pacientes. Sin embargo, en la práctica clínica, las medidas de bioseguridad son aplicadas parcialmente: como media, un 60,2% manifiesta realizar las normas de higiene personal, un 66,1% manifiesta el uso de elementos de protección de barrera y un 44% manifiesta el manejo de objetos cortantes o punzantes. El 32,25% de los estudiantes ha sufrido un accidente biológico, con mayor incidencia en el segundo curso, administrando una inyección (24%), extrayendo sangre con agujas tipo venojet® (18%) y reencapsulando la aguja (17%). Conclusiones. El alto grado de conocimiento que manifiestan tener los estudiantes sobre las precauciones estándares no se demuestra en la práctica clínica. Se observan importantes deficiencias en las prácticas de seguridad de los estudiantes ya que el reencapsulado de la aguja sigue siendo una de las prácticas de riesgo más frecuente(AU)

Objective. To identify the degree of knowledge and performance of bio-safety measures by nursing students and knowing the type of biological accidents suffered during their clinical practice. Method. A cross-sectional study was conducted on the students of three Nursing courses held in May of 2008. Data was collected by an anonymous self-administered questionnaire, with a return of 54%. Results. A total of 97% of students seemed to know the standard biosafety measures, and all of them (100%) stated that those measures must be applied to every patient. However, the reality of clinical practice shows that biosafety measures are only partially applied. An average of 60.2% implement the personal hygiene measures, 66.1% use physical barriers, and 44% use sharp materials safely. Results. Around 32.25% of the students have suffered some biological accident, with a greater incidence in the second year: administering injections (24%), drawing blood samples with Venojet® needles (18%) and recapping used needles (17%). Conclusions. The high level of knowledge shown by the students on standard precautions is not always shown in clinical practice. There are significant deficiencies in student safety practices: recapping of used needles continues to be one of the most common risk practices carried out(AU)

[Knowledge and adherence to bio-safety measures and biological accidents by nursing students during their clinical practice]. / Conocimiento y cumplimiento de las medidas de bioseguridad y accidentes biológicos de los estudiantes de enfermería en las prácticas clínicas.

OBJECTIVE: To identify the degree of knowledge and performance of bio-safety measures by nursing students and knowing the type of biological accidents suffered during their clinical practice. METHOD: A cross-sectional study was conducted on the students of three Nursing courses held in May of 2008. Data was collected by an anonymous self-administered questionnaire, with a return of 54%. RESULTS: A total of 97% of students seemed to know the standard biosafety measures, and all of them (100%) stated that those measures must be applied to every patient. However, the reality of clinical practice shows that biosafety measures are only partially applied. An average of 60.2% implement the personal hygiene measures, 66.1% use physical barriers, and 44% use sharp materials safely. Around 32.25% of the students have suffered some biological accident, with a greater incidence in the second year: administering injections (24%), drawing blood samples with Venojet needles (18%) and recapping used needles (17%). CONCLUSIONS: The high level of knowledge shown by the students on standard precautions is not always shown in clinical practice. There are significant deficiencies in student safety practices: recapping of used needles continues to be one of the most common risk practices carried out.