title: Evaluation of the injury impairment scale, a tool to predict road crash sequelae, in a French cohort of road crash survivors.
abstract: OBJECTIVE
  The objective of the present study was to validate sequelae prediction by the Maximal Injury Impairment Score (M-IIS) in comparison with the Functional Independence Measure (FIM) assessed at 1-year follow-up of severe road crash victims.
  
  
  METHODS
  The study population came from "the Etude et Suivi d'une Population d'Accidentés de la Route dans le Rhône" (ESPARR; Rhône Area Road Crash Victim Follow-up Study) cohort: 178 victims (with Maximal Abbreviated Injury Scale ≥ 3) of road crashes in the Rhône administrative department of France, aged ≥ 16 years and with medical examination including FIM scoring 1 year postaccident. Two thresholds were tested for both scores. Firstly, the relation between FIM and M-IIS was assessed on logistic regression models adjusted on age and presence of complications at 1 year postaccident. The predictive capacity of M-IIS was expressed as its negative and positive predictive values and was considered good when 80 percent or better.
  
  
  RESULTS
  Sixty-three of the 178 adult subjects (mean age = 37.7 years; range = 16.1-82.9 years) showed postaccident complications. One-year sequelae prediction on M-IIS was greater in head, spine, and limb lesions but limited to slight impairments (M-IIS = 1). There was a significant correlation between FIM and M-IIS, although age and medical complications were confounding factors on certain multivariate models. The predictive capacity of M-IIS was low for all types of sequelae.
  
  
  CONCLUSIONS
  M-IIS, in this severely injured population, failed to predict sequelae at 1 year as measured by the FIM, despite a good correlation between the two. Complications are to be taken into account in assessing the M-IIS's capacity to predict sequelae. Further evaluation will be needed on larger series or assessment of other indicators and measures of sequelae at 1 year to obtain a robust tool to predict road crash sequelae.
authors.affiliation: Université de Lyon, UMRESTTE-IFSTTAR, Lyon, France.
authors.forename: Hoang-Thy
authors.initials: HT
authors.lastname: Nhac-Vu
authors.forename: Martine
authors.initials: M
authors.lastname: Hours
authors.forename: Pierrette
authors.initials: P
authors.lastname: Charnay
authors.forename: Laetitia
authors.initials: L
authors.lastname: Chossegros
authors.forename: Dominique
authors.initials: D
authors.lastname: Boisson
authors.forename: Jacques
authors.initials: J
authors.lastname: Luauté
authors.forename: Bernard
authors.initials: B
authors.lastname: Laumon
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D015203:Reproducibility of Results; D017741:Survivors / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D055815:Young Adult