Comparison of Revised Trauma Score, Injury Severity Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Traumatic Patients

Yousefzadeh-Chabok, Shahrokh; Hosseinpour, Marieh; Kouchakinejad–Eramsadati, Leila; Ranjbar, Fatemeh; Malekpouri, Reza; Razzaghi, Alireza; Mohtasham-Amiri, Zahra

doi:10.5505/tjtes.2016.93288

Cited by 12 publications

(5 citation statements)

References 23 publications

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“…In a study by Yousefzadeh-Chabok et al ., mean plus standard deviation of ISS for non-survivors was 15.95±10.46 and 7.31±6.22 for survivors; mean plus standard deviation of RTS for former was 5.65±1.82, and 7.79±0.27 for latter group. Mean plus standard deviation of TRISS for non-survivors was 1.04±1.49 and was 3.49±0.6 for survivors 23 .…”

Section: Methodsmentioning

confidence: 92%

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Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients

Javali

Krishnamoorthy

Patil

et al. 2019

Indian Journal of Critical Care Medicine

116

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Objectives This study tests the accuracy of the Injury Severity Score (ISS), New Injury Severity Score (NISS), Revised Trauma Score (RTS) and Trauma and Injury Severity Score (TRISS) in prediction of mortality in cases of geriatric trauma. Design Prospective observational study Materials and methods This was a prospective observational study on two hundred elderly trauma patients who were admitted to JSS Hospital, Mysuru over a consecutive period of 18 months between December 2016 to May 2018. On the day of admission, data were collected from each patient to compute the ISS, NISS, RTS, and TRISS. Results Mean age of patients was 66.35 years. Most common mechanism of injury was road traffic accident (94.0%) with mortality of 17.0%. The predictive accuracies of the ISS, NISS, RTS and the TRISS were compared using receiver operator characteristic (ROC) curves for the prediction of mortality. Best cutoff points for predicting mortality in elderly trauma patient using TRISS system was a score of 91.6 (sensitivity 97%, specificity of 88%, area under ROC curve 0.972), similarly cutoff point under the NISS was score of 17(91%, 93%, 0.970); for ISS best cutoff point was at 15(91%, 89%, 0.963) and for RTS it was 7.108(97%,80%,0.947). There were statistical differences among ISS, NISS, RTS and TRISS in terms of area under the ROC curve ( p <0.0001). Conclusion TRISS was the strongest predictor of mortality in elderly trauma patients when compared to the ISS, NISS and RTS. How to cite this article Javali RH, Krishnamoorthy et al . Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients. Indian J of Crit Care Med 2019;23(2):73-77.

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Section: Methodsmentioning

confidence: 92%

“…In Aydin et al study, area under ROC curve using ISS, NISS and TRISS for predicting death was 0.907, 0.914 and 0.934, respectively 22 . In Yousefzadeh-Chabok et al study, area under ROC curve using ISS, RTS and TRISS for predicting death was 0.76, 0.87 and 0.94, respectively 23 .…”

Section: Methodsmentioning

confidence: 92%

Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients

Javali

Krishnamoorthy

Patil

et al. 2019

Indian Journal of Critical Care Medicine

116

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“…Most studies showed that the NISS and TRISS were better than the ISS for the prediction of outcome in trauma patients [ 31 ]. Yousefzadeh-Chabok et al reported the AUCs of the ISS and TRISS in predicting mortality among geriatric trauma patients were 0.76 and 0.94 [ 32 ]. Homanna Javali et al also compared the ISS, NISS, and TRISS for predicting mortality in cases of geriatric trauma, and the corresponding AUCs were 0.963, 0.970, and 0.972, respectively [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

The incidence of geriatric trauma is increasing and comparison of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients

2020

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Purpose The study aimed to examine the changing incidence of geriatric trauma and evaluate the predictive ability of different scoring tools for in-hospital mortality in geriatric trauma patients. Methods Annual reports released by the National Trauma Database (NTDB) in the USA from 2005 to 2015 and the Trauma Register DGU® in Germany from 1994 to 2012 were analyzed to examine the changing incidence of geriatric trauma. Secondary analysis of a single-center cohort study conducted among 311 severely injured geriatric trauma patients in a level I trauma center in Switzerland was completed. According to the in-hospital survival status, patients were divided into the survival and non-survival group. The differences of the ISS (injury severity score), NISS (new injury severity score), TRISS (Trauma and Injury Severity Score), APACHE II (Acute Physiology and Chronic Health Evaluation II), and SPAS II (simplified acute physiology score II) between two groups were evaluated. Then, the areas under the receiver-operating characteristic curve (AUC-ROC) of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients were calculated. Results The analysis of the NTDB showed that the increase in the number of geriatric trauma ranged from 18 to 30% between 2005 and 2015. The analysis of the DGU® showed that the mean age of trauma patients rose from 39.11 in 1993 to 51.10 in 2013, and the proportion of patients aged ≥ 60 years rose from 16.5 to 37.5%. The findings from the secondary analysis showed that 164 (52.73%) patients died in the hospital. The ISS, NISS, APACHE II, and SAPS II in the death group were significantly higher than those in the survival group, and the TRISS in the death group was significantly lower than those in the survival group. The AUCs of the ISS, NISS, TRISS, APACHE II, and SAPS II for the prediction of in-hospital mortality in geriatric trauma patients were 0.807, 0.850, 0.828, 0.715, and 0.725, respectively. Conclusion The total number of geriatric trauma is increasing as the population ages. The accuracy of ISS, NISS and TRISS was higher than the APACHE II and SAPS II for the prediction of in-hospital mortality in geriatric trauma patients.

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“…In a comparison of results of RTS or ISS, TRISS was a stronger predictor of mortality in elderly trauma patients as result of the combination of both anatomical and physiological parameters [ 16 ]. A hybrid model incorporating the anatomical and physiological aspects of the trauma patients is expected to have heightened discriminatory abilities for predicting mortality outcomes.…”

Section: Discussionmentioning

confidence: 99%

Significance of Blood Transfusion Units in Determining the Probability of Mortality among Elderly Trauma Patients Based on the Geriatric Trauma Outcome Scoring System: A Cross-Sectional Analysis Based on Trauma Registered Data

Rau

Kuo

et al. 2018

IJERPH

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Background: For elderly trauma patients, a prognostic tool called the Geriatric Trauma Outcome Score (GTOS), where GTOS = (age) + (ISS × 2.5) + (22 if any packed red blood cells (pRBCs) were transfused within 24 h after admission), was developed for predicting mortality. In such calculation, a score of 22 was added in the calculation of GTOS regardless of the transfused units of blood. This study aimed to assess the effect of transfused blood units on the mortality outcomes of the elderly trauma patients who received blood transfusion (BT). Methods: Detailed data of 687 elderly trauma patients aged ≥65 years who were transfused with pRBCs within 24 h after admission into a level I trauma center between 1 January 2009 and 31 December 2016 were retrieved from the Trauma Registry System database. Based on the units of pRBCs transfused, the study population was divided into two groups to compare the mortality outcomes between these groups. Adjusted odds ratios (AORs) with its 95% confidence intervals (CIs) for mortality were calculated by adjusting sex, pre-existing comorbidities, and GTOS. Results: When the cut-off value of BT was set as 3 U of pRBCs, patients who received BT ≥ 3 U had higher odds of mortality than those who received BT < 3 U (OR, 3.0; 95% CI, 1.94–4.56; p < 0.001). Patients who received more units of pRBCs still showed higher odds of mortality than their counterparts. After adjusting for sex, pre-existing comorbidities, and GTOS, comparison revealed that the patients who received BT of 3 U to 6 U had a 1.7-fold adjusted odds of mortality than their counterparts. The patients who received BT ≥ 8 U and 10 U had a 2.1-fold (AOR, 2.1; 95% CI, 1.09–3.96; p < 0.001) and 4.4-fold (AOR, 4.4; 95% CI, 2.04–9.48; p < 0.001) adjusted odds of mortality than those who received BT < 8 U and <10 U, respectively. Conclusions: This study revealed that the units of BT did matter in determining the probability of mortality. For those who received more units of blood, the mortality may be underestimated according to the GTOS.

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Comparison of Revised Trauma Score, Injury Severity Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Traumatic Patients

Abstract: BACKGROUND: Trauma is the fifth leading cause of death in patients 65 years and older. This study is a comparison of results of Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) in prediction of mortality in cases of geriatric trauma.

Cited by 12 publications

References 23 publications

Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients

Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients

The incidence of geriatric trauma is increasing and comparison of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients

Significance of Blood Transfusion Units in Determining the Probability of Mortality among Elderly Trauma Patients Based on the Geriatric Trauma Outcome Scoring System: A Cross-Sectional Analysis Based on Trauma Registered Data

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