The injury severity score in pregnant trauma patients: predicting placental abruption and fetal death.
BACKGROUND
The Injury Severity Score (ISS) is the national standard for injury severity assessment but has been rarely validated in the pregnant population.


METHODS
We evaluated 294 pregnant women who were hospitalized for injury in Washington State from 1989 to 1997. We used ICDMAP-90 computer software to assign an ISS to all women. We identified injured pregnant women who experienced a placental abruption or a fetal death using the Washington State delivery hospitalization data and the birth certificate or fetal death records. We evaluated the accuracy of the ISS in predicting these adverse outcomes using sensitivity analysis.


RESULTS
We found that the ISS was not accurate in predicting placental abruption and fetal death. We also found that relatively minor injuries were associated with adverse pregnancy outcomes.


CONCLUSIONS
A more comprehensive injury assessment tool is needed to accurately predict adverse outcomes in the pregnant trauma population.
Schiff
Melissa A
MA
School of Public Health, Department of Epidemiology, University of Washington, Seattle, USA. mschiff@u.washington.edu
Holt
Victoria L
VL
D000037:Abruptio Placentae / Q000453:epidemiology*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D015601:Injury Severity Score; D008428:Maternal Mortality; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014861:Washington / Q000453:epidemiology; D014947:Wounds and Injuries / Q000150:complications*