1. The Barell Body Region by Nature of Injury Diagnosis Matrix Aharonson-Daniel L Presenting the work of the late Vita Barell in conjunction with Avitzour M, Boyko V, Ziv A, Heruti R, Abargel A, ISRAEL Mackenzie E, Fingerhut L, USA And many dear friends from the ICE on Injury The Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Israel

2. The Matrix is a tool for classifying injury ICD-9-CM codes by body region and nature of injury. It is useful for standardized retrieval of injury cases for epidemiological, clinical and management oriented analyses. What is the Matrix?

3. To characterize the patterns of injury Matrix objectives To serve as a standard for casemix comparison To simplify the process of classifying injuries To provide a standard format for reports

4. Motivation for building the matrix Sorted by nature of injury Detecting injuries by body region requires collating codes across chapters ICD 9-CM CODES 800-995

5. ICD 9-CM CODES 800-995 Motivation for building the matrix nature of injury body region

6. The Matrix structure Nature of injury Body Region ICD-9-CM injury codes

7. Nature of injury (Columns) are based on Sequence of codes in ICD-9-CM codebook 12 Nature of Injury Columns Fractures, dislocations, sprains & strains, internal, open wounds, amputations, blood vessels, contusions/superficial, crush, burn, nerves unspecified

8. 3 standard levels of detail 5 rows 10 rows 36 rows Body Region (Rows) are based on : Anatomic subgroups High Incidence Variability in Outcome Difference in health care utilization

9. * T h e M a t r i x i s a v a il a b l e o n t h e n e t a t w w w. c d c. g o v / n c h s / a b o u t/ o t h e r a c t/ i c e / b a r e ll m a t r i x. h t m matrix

10. * T h e M a t r i x i s a v a il a b l e o n t h e n e t a t w w w. c d c. g o v / n c h s / a b o u t/ o t h e r a c t/ i c e / b a r e ll m a t r i x. h t m Zoom on matrix

11. Example 800.4 Skull fracture 850 Concussion Head 860 Flail chest 824 Fractured ankle Fractures InternalBlood Vessels Lower extremity Spinal Cord Chest Jack – skull # Jill - concussion John – Flail chest Peter - # ankle

12. (50) Head 0(0) 1 (25) 1 Number % Lower extremity Spinal Cord Chest Summary Report N 2 4 Total100

13. Summary report in practice

14. Using report for comparisons

15. Forthcoming developments Collaboration with CDC NCIPC, academic and other Neurological organizations about the structure and interpretation of Severity of TBI rows Develop standard methods for summarizing multiple injuries Translate into ICD-10

16. Thanks for your attention The matrix is also on the net at: www.cdc.gov/nchs/projects/barellmatrix.htm A handout of the matrix is available