The future

Reliable methods of controlling for case-mix differences in injured patients are essential for the scientific study of injury. Without them, epidemiological studies would lack perspective and interventional studies would be severely confounded unless governed by extraordinarily tight case definitions that would seriously restrict patient sample sizes. Severity scales also have potential applications in estimating and prescribing resource needs, and thus are an essential tool in the drive for more cost-effective care. As databases become linked, the combination of automobile crash information, clinical, financial, and rehabilitative databases will allow greater perspective on the impact of injury.

In some respects the widely used scoring systems are primitive, focus on mortality, and are not robust enough for many important applications. Substantial refinement is required to link injury severity with the many outcomes other than death.

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