title: Towards valid 'serious non-fatal injury' indicators for international comparisons based on probability of admission estimates.
abstract: Governments wish to compare their performance in preventing serious injury. International comparisons based on hospital inpatient records are typically contaminated by variations in health services utilisation. To reduce these effects, a serious injury case definition has been proposed based on diagnoses with a high probability of inpatient admission (PrA). The aim of this paper was to identify diagnoses with estimated high PrA for selected developed countries.
  
  
  
  The study population was injured persons of all ages who attended emergency department (ED) for their injury in regions of Canada, Denmark, Greece, Spain and the USA. International Classification of Diseases (ICD)-9 or ICD-10 4-digit/character injury diagnosis-specific ED attendance and inpatient admission counts were provided, based on a common protocol. Diagnosis-specific and region-specific PrAs with 95% CIs were calculated.
  
  
  
  The results confirmed that femoral fractures have high PrA across all countries studied. Strong evidence for high PrA also exists for fracture of base of skull with cerebral laceration and contusion; intracranial haemorrhage; open fracture of radius, ulna, tibia and fibula; pneumohaemothorax and injury to the liver and spleen. Slightly weaker evidence exists for cerebellar or brain stem laceration; closed fracture of the tibia and fibula; open and closed fracture of the ankle; haemothorax and injury to the heart and lung.
  
  
  
  Using a large study size, we identified injury diagnoses with high estimated PrAs. These diagnoses can be used as the basis for more valid international comparisons of life-threatening injury, based on hospital discharge data, for countries with well-developed healthcare and data collection systems.
authors: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors: Colin
authors: C
authors: Cryer
authors: Pacific Institute for Research and Evaluation, Calverton, Maryland, USA.|Curtin University Centre for Health Policy Research, Perth, Australia.
authors: Ted R
authors: TR
authors: Miller
authors: Farr Institute, Swansea University Medical School, Swansea, UK.
authors: Ronan A
authors: RA
authors: Lyons
authors: School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
authors: Alison K
authors: AK
authors: Macpherson
authors: Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain.|CIBER Epidemiología y Salud Pública, Institute of Biomedical Research (IIBSP), Barcelona, Spain.
authors: Katherine
authors: K
authors: Pérez
authors: Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Eleni Th
authors: ET
authors: Petridou
authors: Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Nick
authors: N
authors: Dessypris
authors: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors: Gabrielle S
authors: GS
authors: Davie
authors: School of Population Health, University of Auckland, Auckland, New Zealand.
authors: Pauline J
authors: PJ
authors: Gulliver
authors: Injury Prevention Group, Odense University Hospital, Odense, Denmark.|Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark.
authors: Jens
authors: J
authors: Lauritsen
authors: Transport and Road Safety Research, University of New South Wales, Sydney, New South Wales, Australia.
authors: Soufiane
authors: S
authors: Boufous
authors: Pacific Institute for Research and Evaluation, Calverton, Maryland, USA.
authors: Bruce
authors: B
authors: Lawrence
authors: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors: Brandon
authors: B
authors: de Graaf
authors: Division of Healthcare Delivery Data, Measures and Research, Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland, USA.
authors: Claudia A
authors: CA
authors: Steiner
mesh_terms: D002170:Canada / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D006077:Government Agencies / Q000706:statistics & numerical data; D006115:Greece / Q000453:epidemiology; D006302:Health Services Research; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data*; D038622:Internationality; D016015:Logistic Models; D011336:Probability; D013030:Spain / Q000453:epidemiology; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control