scholarly journals Assessment of trauma and injury severity score model for survival of trauma patients: a single centre experience

2018 ◽  
Vol 5 (7) ◽  
pp. 2550
Author(s):  
Umesh Gaikwad Gaikwad ◽  
Nitin Wasnik ◽  
Divish Saxena ◽  
Murtaza Akhtar

Background: Trauma and Injury Severity Score (TRISS) designed by Major Trauma Outcome Study (MTOS) in United States, is commonly used for outcome prediction in polytrauma patients. It determines the probability of survival (PS) of a patient from the Injury Severity Score (ISS) and Revised Trauma Score (RTS) using TRISS methodology.Methods: A total number of 136 patients presenting within 24 hours of trauma that were admitted were included in the study. The probability of survival was calculated using TRISS index (RTS, ISS, and age combination index). The predicted probability of survival and that of death among the study subjects were calculated using TRISS. A cut off 0.5 or lesser of TRISS score was taken as death and above 0.5 as survival status.Results: The mean TRISS among males and females were 86.12±21.76 and 79.49±27.70 and based on TRISS score the expected deaths were predicted to be 11.03%. But, in actual, the deaths were 23.52% showing a negative correlation with TRISS score in our set up thereby indicating a need to improve emergency facilities for trauma patients.Conclusions: TRISS methodology when applied to our setup predicted fewer deaths as compared to the actual deaths and also did not accurately predict the survival in the trauma patients.

2015 ◽  
Vol 49 (spe) ◽  
pp. 138-146 ◽  
Author(s):  
Cristiane de Alencar Domingues ◽  
Lilia de Souza Nogueira ◽  
Cristina Helena Costanti Settervall ◽  
Regina Marcia Cardoso de Sousa

RESUMO Objetivo identificar estudos que realizaram ajustes na equação do Trauma and InjurySeverity Score (TRISS) e compararam a capacidade discriminatória da equação modificada com a original. Método Revisão integrativa de pesquisas publicadas entre 1990 e 2014 nas bases de dados LILACS, MEDLINE, PubMed e SciELO utilizando-se a palavra TRISS. Resultados foram incluídos 32 estudos na revisão. Dos 67 ajustes de equações do TRISS identificados, 35 (52,2%) resultaram em melhora na acurácia do índice para predizer a probabilidade de sobrevida de vítimas de trauma. Ajustes dos coeficientes do TRISS à população de estudo foram frequentes, mas nem sempre melhoraram a capacidade preditiva dos modelos analisados. A substituição de variáveis fisiológicas do Revised Trauma Score (RTS) e modificações do Injury Severity Score (ISS) na equação original tiveram desempenho variado. A mudança na forma de inclusão da idade na equação, assim como a inserção do gênero, comorbidades e mecanismo do trauma apresentaram tendência de melhora do desempenho do TRISS. Conclusão Diferentes propostas de ajustes no TRISS foram identificadas nesta revisão e indicaram, principalmente, fragilidades do RTS no modelo original e necessidade de alteração da forma de inclusão da idade na equação para melhora da capacidade preditiva do índice.


2020 ◽  
Author(s):  
Chiaki Toida ◽  
Takashi Muguruma ◽  
Masayasu Gakumazawa ◽  
Mafumi Shinohara ◽  
Takeru Abe ◽  
...  

Abstract Background: In-hospital mortality in trauma patients decreased recently owing to improved trauma injury prevention systems. However, no study which evaluated the validity of Trauma and Injury Severity Score (TRISS) in pediatrics by detailed classification of patients’ age and injury severity in Japan. This retrospective nationwide study evaluated the validity of TRISS in predicting survival in Japanese pediatric patients with blunt trauma by age and injury severity.Methods: Data were obtained from the Japan Trauma Data Bank during 2009−2018.Results: In all age categories, the area under the curve (AUC) for TRISS demonstrated high performance (0.935, 0.981, 0.979, and 0.977). The Accuracy of TRISS was 99.9%, 98.2%, 92.1%, 76.7%, 55.3%, and 72.1% in survival probability (Ps) interval groups (0.96−1.00), (0.91−0.95), (0.76.−0.90), (0.51−0.75), (0.26−0.50), and (0.00−0.25), respectively. The AUC for TRISS demonstrated moderate performance in the Ps interval group (0.96−1.00) and low performance in other Ps interval groups.Conclusions: The TRISS methodology appears to predict survival accurately in Japanese pediatric patients with blunt trauma; however, there were several problems in adopting the TRISS methodology for younger blunt trauma patients with higher injury severity. In the future, we should consider to conducting a simple, high-quality prediction model that is more suitable for pediatric trauma patients than the current TRISS model.


Author(s):  
Luis Fernando Spagnuolo Brunello ◽  
Ana Luísa Bettega ◽  
Phillipe Geraldo Teixeira de Abreu Reis ◽  
Flávio Daniel Saavedra Tomasich ◽  
Iwan Augusto Collaço ◽  
...  

RESUMO Objetivo: avaliar a influência do local de ocorrência do trauma nos escores de trauma de pacientes submetidos à laparotomia de emergência. Métodos: estudo retrospectivo observacional analítico. Foram incluídos 212 pacientes submetidos à laparotomias exploratórias no período de janeiro de 2015 e dezembro de 2017. Informações sobre o local do acidente e dados vitais dos pacientes foram obtidas com base na coleta de dados por meio de prontuários eletrônicos e físicos. Foram analisados os índices de trauma de pacientes provenientes de Curitiba e Região Metropolitana e o local em que o paciente foi socorrido (estabelecimento físico ou via pública). Resultados: entre os 212 pacientes estudados, 184 (86,7%) foram trazidos pelo Serviço de Atendimento Pré-Hospitalar provenientes da cidade Curitiba e 28 (13,3%) provenientes de Região Metropolitana de Curitiba. Foram socorridos em estabelecimentos físicos 25 pacientes (17,6%), enquanto 117 (82,4%) foram socorridos em via pública. Observou-se maiores valores de ISS (Injurity Severity Score) dos pacientes procedentes da Região Metropolitana em relação aos procedentes de Curitiba (29,78 vs 22,46, P=0,009), enquanto valores maiores do TRISS (Trauma Trauma and Injury Severity Score) foram observados em pacientes procedentes de Curitiba em relação aos da Região Metropolitana (90,62 vs 81,30; P=0,015). Pacientes socorridos em via pública apresentaram menor valor de RTS (Revised Trauma Score) (6,96 vs 7,65; P=0,024) e TRISS (86,42 vs 97,21; P=0,012). Conclusão: pacientes vítimas de trauma procedentes de locais mais distantes do atendimento no centro de referência apresentaram pior prognóstico à admissão e foi observado pior prognóstico em pacientes socorridos em via pública.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chiaki Toida ◽  
Takashi Muguruma ◽  
Masayasu Gakumazawa ◽  
Mafumi Shinohara ◽  
Takeru Abe ◽  
...  

Abstract Background In-hospital mortality in trauma patients has decreased recently owing to improved trauma injury prevention systems. However, no study has evaluated the validity of the Trauma and Injury Severity Score (TRISS) in pediatric patients by a detailed classification of patients’ age and injury severity in Japan. This retrospective nationwide study evaluated the validity of TRISS in predicting survival in Japanese pediatric patients with blunt trauma by age and injury severity. Methods Data were obtained from the Japan Trauma Data Bank during 2009–2018. The outcomes were as follows: (1) patients’ characteristics and mortality by age groups (neonates/infants aged 0 years, preschool children aged 1–5 years, schoolchildren aged 6–11 years, and adolescents aged 12–18 years), (2) validity of survival probability (Ps) assessed using the TRISS methodology by the four age groups and six Ps-interval groups (0.00–0.25, 0.26–0.50, 0.51–0.75, 0.76–0.90, 0.91–0.95, and 0.96–1.00), and (3) the observed/expected survivor ratio by age- and Ps-interval groups. The validity of TRISS was evaluated by the predictive ability of the TRISS method using the receiver operating characteristic (ROC) curves that present the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, area under the receiver operator characteristic curve (AUC) of TRISS. Results In all the age categories considered, the AUC for TRISS demonstrated high performance (0.935, 0.981, 0.979, and 0.977). The AUC for TRISS was 0.865, 0.585, 0.614, 0.585, 0.591, and 0.600 in Ps-interval groups (0.96–1.00), (0.91–0.95), (0.76. − 0.90), (0.51–0.75), (0.26–0.50), and (0.00–0.25), respectively. In all the age categories considered, the observed survivors among patients with Ps interval (0.00–0.25) were 1.5 times or more than the expected survivors calculated using the TRISS method. Conclusions The TRISS methodology appears to predict survival accurately in Japanese pediatric patients with blunt trauma; however, there were several problems in adopting the TRISS methodology for younger blunt trauma patients with higher injury severity. In the next step, it may be necessary to develop a simple, high-quality prediction model that is more suitable for pediatric trauma patients than the current TRISS model.


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