RAPEX HARM from AIS 2015 Coded Injuries

The European Unions Safety Gate Rapid Alert System (RAPEX) requires Hazard and Risk Assessment Methodology (HARM) evaluations addressing both injury lethality and long-term consequences (LTC). This paper developed a post-processing method to use AIS 2015-coded trauma data directly for RAPEX HARM assessments. AIS 2015 utilizes two metrics: the AIS Code (AIS-CD) for threat to life and the predicted Functional Capacity Index (pFCI) for LTC. While the AIS-CD has been validated on numerous datasets, the pFCI values are based on a theoretical framework that is pending validation. To counter coding variability and poor alignment with clinical diagnoses, initial AIS identifiers (AIS-IDs) were aggregated to a robust level of detail for both metrics. Individual injury severities (AIS-CD/FCI-CD) were aggregated to the person level using a conversion derived from the three most severe injuries (triples), mirroring the concept of the New Injury Severity Score (NISS). The final HARM Level is the most severe outcome derived independently from either the AIS-CD or FCI-CD triple conversion. Analysis showed over 70% of injuries in the aggregated codebook had no LTC. While AIS-CD dominated lower HARM scores, LTC became more defining with increasing HARM severity for the GIDAS sample. At HARM 4 (highest severity), AIS-CD accounted for 53% of cases, FCI-CD accounted for 16%, and both were equally severe in 31% of cases. This method successfully assigns HARM values to AIS 2015 injuries, providing a more holistic severity measure than the current AIS-CD-only approach. HighlightsO_LINovel method assigns RAPEX HARM values to AIS 2015-coded injuries. C_LIO_LICombines lethality (AIS-code) and long-term consequences (FCI-code) for injury severity assessment. C_LIO_LIAggregates injury severity using the three most severe injuries per person. C_LIO_LILong-term consequences account for 13% and 16% of the highest two HARM ratings, respectively. C_LI