Gaps in injury statistics: multiple injury profiles reveal them and provide a comprehensive account.

OBJECTIVE To demonstrate the benefit of using multiple injury profiles (MIP) as an alternative to "primary diagnosis," for the presentation and analysis of multiple injuries in populations. METHODS Retrospective analysis of national trauma registry data in Israel between 1 January 1998 and 31 December 2002. Multiple diagnoses per patient were recorded. A primary diagnosis was selected for each patient and data were presented twice: first by selecting a primary diagnosis and then using multiple injury profiles. RESULTS 23 909 transport casualties were included. Findings show that MIP enable the identification of all patients with a specific injury, even where secondary. The proportion of additional injuries recorded when using MIP ranged from 12% in head injuries to 270% for facial injuries. Based on the primary diagnosis patients with head, chest, and abdominal injuries had a 5-6% inpatient death rate each. Multiple injury profiles of the same population reveal that an isolated head injury has a 3% inpatient death rate, isolated chest and isolated abdomen have a 1% inpatient death rate, while combined head and chest casualties have a 21% inpatient death rate. CONCLUSIONS Multiple injury profiles are a new approach that enables presenting an improved picture of injury in a population.