A Comparison Study of the Injury Score Models

Abstract

Background: A central component to the statistical analysis of trauma care is the probability of survival model, which predicts outcome of the trauma event taking into account various anatomical and physiological factors. One of the key input information to the survival model is the injury score which forms the cornerstone of trauma epidemiology. There are many scoring systems currently in use, and the Injury Severity Score (ISS) as the anatomical component of the injury in the probability of survival model is a widely used one. This paper examines the possibility of representing the anatomical component of the trauma using different injury severity scoring methods described in the literature. Material and methods:The dataset used consists of 75,371 cases from the Trauma Audit and Research Network (TARN). TARN regroups 110 hospitals in the UK and it is the largest European trauma registry. Various limitations of ISS have been described in the literature and an investigation into other scoring methods, which could be calculated from the available data, was proposed. Using the available database, the alternative injury scoring methods can be calculated and their use within a Trauma score and Injury Severity Score (TRISS) probability of survival model is assessed. Results: The current score performs reasonably well, but there is some improvement in calibration associated with introducing a score, which takes into account body-region locations of all injuries.

Systematic review of predictive performance of injury severity scoring tools

“…We identified 16 studies that reported 24 pairs of AUROCs of the ISS and NISS [3,7,9,10,14,15,37,39,51,53,58,66,72,74,78,79]. Among the 24 pairs of AUROCs, eight pairs demonstrated that the ISS had a greater AUROC than the NISS [9,15,39,58,74,78], whereas the other 16 pairs showed greater AUROCs for the NISS than for the ISS.…”

“…Among the 24 pairs of AUROCs, eight pairs demonstrated that the ISS had a greater AUROC than the NISS [9,15,39,58,74,78], whereas the other 16 pairs showed greater AUROCs for the NISS than for the ISS. There were seven pairs of AUROCs that were derived using only blunt trauma patients [7,37,39,51,58,74,78]. Among these seven pairs, only one pair had a higher AUROC for the ISS than the NISS [39].…”

“…There were seven pairs of AUROCs that were derived using only blunt trauma patients [7,37,39,51,58,74,78]. Among these seven pairs, only one pair had a higher AUROC for the ISS than the NISS [39]. There were four pairs of AUROCs that were derived using penetrating trauma patients [51,58,74,78].…”

Trust, social support and patient type—Associations between patients perceived trust, supportive communication and patients preferences in regard to paternalism, clarification and participation of severely injured patients

“…An ISS score ! 16 characterized a seriously injured patient (major trauma) and is linked with a prognosis of mortality of >10% [35].…”

Nursing challenges with a severely injured patient in critical care

“…Other injury scoring systems exist, such as the New Injury Severity Score (NISS) or International Classification of Diseases (ICD‐9) Injury Severity Score (ICISS) (Osler et al ., , ). However, although historic, ISS is most commonly used for major trauma in UK (Dillon et al ., ), both clinically and for research and data governance. ISS is an internationally recognized anatomical scoring system which uses the Abbreviated Injury Score (AIS) to identify the most severely injured body regions.…”