Determining the most effective level of TRISS‐derived probability of survival for use as an audit filter

Kelly, Anne‐Maree; Nicholl, Jon; Turner, Janette

doi:10.1046/j.1442-2026.2002.00309.x

Cited by 19 publications

(13 citation statements)

References 11 publications

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“…[2][3][4][5][7][8][9]11,12,[14][15][16][17]21,22,[24][25][26][28][29][30][31][32][34][35][36][37][38][39] Most articles were published in English-speaking countries, especially in the United States (51.7%), England (17.2%), and Australia (13.8%). They were mostly published in English (96.6%) and the largest number of authors in a study was 12.…”

Section: Resultsmentioning

confidence: 99%

Mortes evitáveis em vítimas com traumatismos

Settervall

Domingues

Sousa³

et al. 2012

Rev. Saúde Pública

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OBJETIVO: Descrever métodos e estimativas de mortalidade proporcional por mortes evitáveis e tipos de não conformidades do atendimento relacionadas a esses eventos. MÉTODOS: Revisão sistemática de publicações sobre mortes evitáveis em vítimas com traumatismos entre 2000 e 2009. Foi realizada pesquisa nas bases de dados Lilacs, SciELO e Medline utilizando-se a estratégia de busca com as palavras-chave "trauma", "avoidable", "preventable", "interventions" e "complications", e os descritores em ciências da saúde "death", "cause of death" e "hospitals". RESULTADOS: Identificaram-se 29 artigos publicados no período, com predomínio de estudos retrospectivos (96,5%). Os métodos mais comumente utilizados para definir a evitabilidade do óbito foram painel de especialistas ou pontuação de índices de gravidade, tendo sido empregadas as seguintes categorias: evitável, potencialmente evitável e não evitável. A média da mortalidade proporcional por mortes evitáveis dos estudos foi de 10,7% (dp 11,5%). As não conformidades mais comumente relatadas nas publicações foram sistema inadequado de atendimento ao traumatizado e erro na avaliação e tratamento. CONCLUSÕES: Observaram-se falhas na uniformização dos termos empregados para categorizar as mortes e as não conformidadades encontradas. Portanto, sugere-se a padronização da taxonomia da classificação das mortes e dos tipos de não conformidades observadas.

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Section: Resultsmentioning

confidence: 99%

Mortes evitáveis em vítimas com traumatismos

Settervall

Domingues

Sousa³

et al. 2012

Rev. Saúde Pública

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“…38 In contrast, the cutoff of 0.33 demonstrated 86% sensitivity and only 8% of avoidable deaths were missed. 38 However, in a smaller sample of patients (n = 24), the cutoff of 0.50 has been shown to be accurate. 41 Given the differences across different trauma data sets, such as proportion of injury types included and the mortality rates, it is unlikely that one particular cutoff will prove accurate in all cases.…”

Section: Practical Applications Of Trissmentioning

confidence: 99%

“…38 In a study of 222 trauma deaths, the 0.50 cutoff was shown to be only 76% sensitive, missing 20% of avoidable deaths. 38 In contrast, the cutoff of 0.33 demonstrated 86% sensitivity and only 8% of avoidable deaths were missed. 38 However, in a smaller sample of patients (n = 24), the cutoff of 0.50 has been shown to be accurate.…”

Section: Practical Applications Of Trissmentioning

confidence: 99%

“…1 The use of the terms ''unexpected survivor'' and ''unexpected death'' has been criticized in the literature. 14,37,38 Patients who die with a calculated probability of survival of 50% or above are considered unexpected, whereas patients who survive with a TRISS probability of survival lower than 50% are considered unexpected survivors. However, this approach fails to take into account uncertainty in the predicted probability, an uncertainty that is large when attempting to predict outcome for an individual patient, relative to predicting an average outcome for a patient group.…”

Section: Practical Applications Of Trissmentioning

confidence: 99%

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TRISS: Does It Get Better than This?

Gabbe

Cameron

Wolfe

2004

Academic Emergency Medicine

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The Trauma and Injury Severity Scoring (TRISS) system was developed in the 1980s to improve the prediction of patient outcomes following trauma through the use of physiological and anatomical criteria. The TRISS is used for a number of purposes, including quantifying the severity of injury of a patient population, calculating the probability of survival of patients for identification of cases for peer review, and comparing the death or survival rates of different populations/hospitals. Despite the advancements in trauma care, improved statistical techniques, and the identification of numerous limitations of TRISS, it continues to be the most commonly used tool for judging hospital performance and monitoring trauma death rates. This article critically evaluates the development, structure, and practical use of TRISS to determine its value in the current trauma environment. Limitations of TRISS are discussed and suggestions are made for the future development of trauma prediction tools.

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“…This convention was established in the initial methodology of both, but there is no clear evidence as to why this mark was chosen. Indeed, Kelly et al [71] have argued that a better mark would be Ps 0.33 (ASCOT Pd 0.66). Table 4 shows the criterion to identify mathematical unexpected survivors for each of the scoring systems used to analyse UK JTTR.…”

Section: Unexpected Outcomesmentioning

confidence: 99%

The role of trauma scoring in developing trauma clinical governance in the Defence Medical Services

Rußell

Hodgetts

McLeod

et al. 2011

Phil. Trans. R. Soc. B

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This paper discusses mathematical models of expressing severity of injury and probability of survival following trauma and their use in establishing clinical governance of a trauma system. There are five sections: (i) Historical overview of scoring systems-anatomical, physiological and combined systems and the advantages and disadvantages of each. (ii) Definitions used in official statistics-definitions of 'killed in action' and other categories and the importance of casualty reporting rates and comparison across conflicts and nationalities. (iii) Current scoring systems and clinical governance-clinical governance of the trauma system in the Defence Medical Services (DMS) by using trauma scoring models to analyse injury and clinical patterns. (iv) Unexpected outcomes-unexpected outcomes focus clinical governance tools. Unexpected survivors signify good practice to be promulgated. Unexpected deaths pick up areas of weakness to be addressed. Seventy-five clinically validated unexpected survivors were identified over 2 years during contemporary combat operations. (v) Future developments-can the trauma scoring methods be improved? Trauma scoring systems use linear approaches and have significant weaknesses. Trauma and its treatment is a complex system. Nonlinear methods need to be investigated to determine whether these will produce a better approach to the analysis of the survival from major trauma.

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Determining the most effective level of TRISS‐derived probability of survival for use as an audit filter

Cited by 19 publications

References 11 publications

Mortes evitáveis em vítimas com traumatismos

Mortes evitáveis em vítimas com traumatismos

TRISS: Does It Get Better than This?

The role of trauma scoring in developing trauma clinical governance in the Defence Medical Services

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