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Pediatric Relative Head Injury Severity Scale (RHISS)

Purpose: To classify a pediatric trauma patient based on closed head injury using the relative head injury scale (RHISS).

Description

The Relative Head Injury Severity Scale (RHISS) can be used to classify a pediatric patient with closed head injury. The scale is based on the relevant ICD-9 codes at the time of hospital discharge.


Level of Head Injury

Code

none

0

mild

1

moderate

2

severe

3

 

Some relevant ICD-9 codes:

(1) skull fracture: 800, 801, 803, 804

(2) intracranial injury without skull fracture:  850 - 854

 

Parameters:

(1) duration of any loss of consciousness

(2) fracture location

(3) brain injury or contusion

 

Parameter

Finding

Code

loss of consciousness

> 24 hours

3

 

1 - 24 hours

2

 

0.01 - 59 minutes

1

 

none

0

fracture location

base of skull

2

 

vault of skull

1

 

else

0

contusion (brain injury)

any

2

 

"unspecified nature of injury"

1

 

neither

0

 

RHISS =

= MAX(codes for the 3 parameters)

 

RHISS

Mortality

0

< 1%

1

1%

2

5.5%

3

52%

from Figure 3, page 174


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Specialty

Objective

ICD-10