Abstract
BACKGROUND: Head trauma is a significant public health issue in Taiwan. This study examines the differences in medical needs and outcomes for patients with isolated head trauma scored via Taiwan's health insurance versions of the Abbreviated Injury Scale (AIS) and the AIS 2005 update 2008. METHODS: Data from isolated head trauma patients between January 1, 2011, and December 31, 2020, were analyzed via a trauma registry database from a medical center in southern Taiwan. The severity was scored using both the health insurance AIS and the AIS 2005 update 2008. A total of 4,035 patients met the inclusion criteria. RESULTS: The median (IQR) score for the health insurance AIS was 4 (3-4), whereas the AIS 2005 update score was 3 (3-4). The corresponding injury severity scores (ISSs) were 17.33 ± 4.77 and 13.95 ± 5.90, respectively, indicating a significant decrease. Most patients had an AIS score of 4 (65.4%; 2,640) according to the health insurance version, followed by an AIS score of 3 (25.2%; 1,016 patients). When the AIS 2008 version was used, most patients had an AIS score of 3 (52.8%; 2,130 patients), followed by an AIS score of 4 (26.3%; 1,063 patients). CONCLUSIONS: Taiwan's trauma care benchmarks may be outdated. Updating the health insurance AIS is necessary. The health insurance versions AIS and AIS 2005 update 2008 were used to assess the severity of isolated head trauma among inpatients. The two versions resulted in significant differences in the AIS score and total ISS; in particular, the newer version resulted in a decrease in the trauma severity score. This study highlights the substantial differences in resource needs and outcomes when different AIS versions are used. Rigorous research is needed for any revision to meet public expectations for precision public health.