Injury Prevention Priority Score: A New Method for Trauma Centers to Prioritize Injury Prevention Initiatives Adil H Haider, MD, MPH, Donald A Risucci, PhD, Saad Bin Omer, MBBS, MPH, Thomas Sullivan, BS, Stephen M DiRusso, MD, PhD, FACS, John A Savino, MD, FACS, Charles N Paidas, MD, FACS BACKGROUND: Trauma centers are expected to develop injury prevention programs that address needs of the local population. A relatively simple, objective, and quantitative method is needed for priori- tizing local injury prevention initiatives based on both injury frequency and severity. STUDY DESIGN: Pediatric trauma patients (16 years or younger; n = 7,958) admitted to two Level I regional trauma centers (Johns Hopkins Children Center and Westchester Medical Center) from 1993 to 1999 were grouped by injury causal mechanism according to ICD-9 external cause codes. An Injury Prevention Priority Score (IPPS), balancing the influences of severity (based on the Injury Severity Score) and frequency, was calculated for each mechanism and mechanisms were ranked accordingly. RESULTS: IPPS-based rank lists differed across centers. The highest ranked mechanism of injury among chil- dren presenting to Johns Hopkins Children Center was “pedestrian struck by motor vehicle,” and at Westchester Medical Center it was “motor vehicle crash.” Different age groups also had specific injury prevention priorities, eg, “child abuse” was ranked second highest among infants at both centers. IPPS was found to be stable (r = 0.82 to 0.93, p  0.05) across alternate measures of injury severity. CONCLUSIONS: IPPS is a relatively simple and objective tool that uses data available in trauma center registries to rank injury causes according to both frequency and severity. Differences between two centers and across age groups suggest IPPS may be useful in tailoring injury prevention programs to local population needs. ( J Am Coll Surg 2004;198:906–913. © 2004 by the American College of Surgeons) Trauma centers have a tripartite role that includes pre- hospital, in-hospital, and postdischarge responsibilities. Prehospital responsibilities include development and implementation of injury prevention programs tailored to the needs of the individual communities or regions they serve. 1,2 It follows that injury prevention priorities must be established at the local or regional level, or both, and be based on relevant local and regional data. There are no reported reproducible or accepted methods or tools available to individual trauma centers to prioritize specific injury prevention initiatives in their regions. The availability of such methods and tools would be especially useful to trauma centers seeking American College of Surgeons (ACS) Level I status, as these cen- ters are mandated to have active injury prevention programs. 1 The goal of this research is to describe the develop- ment and initial steps toward validation of an objective tool for local, evidence-based prioritization of injury prevention initiatives. We describe an Injury Prevention Priority Score (IPPS), a relatively simple, objective, and quantitative method for ranking injury mechanisms with respect to both frequency and severity of injuries among patient populations treated at a specific trauma center. IPPS uses a computational method that balances the influence of frequency and severity in ranking the relative importance of different injury mechanisms. No competing interests declared. This study was presented at the American College of Surgeons-Committee on Trauma Resident Research Competition, San Diego, CA, April 2002. Received March 28, 2003; Revised January 6, 2004; Accepted February 5, 2004. From the Department of Surgery (Haider, Risucci, Sullivan, DiRusso, Savino), New York Medical College, Valhalla, NY, the Johns Hopkins Bloomberg School of Public Health (Omer), Baltimore, MD, and the Divi- sion of Pediatric Surgery (Paidas), Johns Hopkins School of Medicine, Balti- more, MD. Correspondence address: Adil H Haider, MD, MPH, Department of Surgery, New York Medical College, Westchester Medical Center, Box 489, 95 Grass- lands Rd, Valhalla, NY 10595. email: ahaider@jhsph.edu 906 © 2004 by the American College of Surgeons ISSN 1072-7515/04/$30.00 Published by Elsevier Inc. doi:10.1016/j.jamcollsurg.2004.02.013