New Injury Severity Score and Trauma Injury Severity Score are superior in predicting trauma mortality

Abstract

BACKGROUND:Trauma scores are used to give clinicians appropriate quantitative context in making decisions. Studies show that anatomical trauma scores predicted intensive care unit admission better, while physiological trauma scores predicted mortality better. We hypothesize that trauma scores have a hierarchy of efficacies at predicting mortality and operative decision making. METHODS:We performed a retrospective analysis of our trauma patient database at a level 1 trauma center from 2016 to 2020 and calculated the following trauma scores: Glasgow Coma Scale, Revised Trauma Score, Trauma Injury Severity Score, Injury Severity Score, Shock Index, and New Trauma Injury Severity Score (NISS). Receiver operating characteristic curves were used to evaluate the sensitivity and specificity of trauma scores for predicting mortality. RESULTS:A total of 738 patients were included (mean ± SD age, 35.7 ± 15.6 years). Area under the curve (AUC) results from the DeLong test showed that NISS predicted mortality the best compared with other trauma scores. New Trauma Injury Severity Score was superior in predicting mortality for penetrating trauma (AUC, 0.86 ± 0.02; p < 0.001) compared with blunt trauma (AUC, 0.73 ± 0.04; p < 0.001). Trauma Injury Severity Score was the best predictor of mortality for patients with gunshot wounds (AUC, 0.83; 95% confidence interval [CI], 0.73-0.92; p < 0.001), motor vehicle accidents (AUC, 0.80; 95% CI, 0.61-1.00; p = 0.01), and falls (AUC, 0.73; 95% CI, 0.61-0.85; p = 0.007). CONCLUSION:New Trauma Injury Severity Score was the best scoring index for predicting mortality in trauma patients, especially for penetrating trauma. Clinicians should consider incorporating other trauma scores, especially NISS and Trauma Injury Severity Score, in determining injury severity and the likelihood of mortality. These scores can help physicians determine the best course of action in patient management.

Effects of the establishment of trauma centres on the mortality rate among seriously injured patients: a propensity score matching retrospective study

“…The ISS between the two groups was different ( P = 0.019). The distribution of ISS category [ 18 ] was not significantly different, nor was the surgery selected. However, the time to an emergency operation in the “after trauma centre” group was markedly shorter than that in the “before trauma centre” group ( P < 0.001).…”

Registro de Trauma: análise dos Filtros de Qualidade nos pacientes internados

“…Os "filtros de auditoria" ou Filtros de Qualidade (FQ) são variáveis propostas pelos assistentes de cada serviço a serem monitoradas e que, quando presentes, podem representar oportunidades de melhora para o sistema [20][21][22][23][24][25] Além dos dados clínicos-demográficos, foi realizada a coleta de informações dirigida para avaliação de qualidade de atendimento, através de Filtros de Qualidade/ Auditoria, conforme aqueles já estabelecidos em nosso serviço 35,36 , baseados naqueles propostos inicialmente pelo American College of Surgeons em 199026 adaptando-nos o à realidade de nosso serviço e editando-os (Tabela 1). Houve 17 fraturas de ossos do crânio (3,65%), 21 fraturas de face (4,7%), 9 Hematomas Epidurais (2%), 8 Hematomas Subdurais (1,8%) e 12 contusões cerebrais (2,7%); 42 fraturas de membros superiores (9,1%), 50 de membros inferiores (10,8%) -com apenas 1 lesão vascular periférica -15 de pelve (3,2%) e 18 de coluna (3,9%).…”

Evaluation of intentional and unintentional injuries in children and adolescents with trauma scoring systems

“…The Injury Severity Score (ISS) and New Injury Severity Score (NISS) are valuable trauma scoring systems in showing trauma severity (9). The NISS is one of the trauma scoring systems that best predict mortality [10]. Li and Ma reported that NISS was more valuable than ISS in predicting mortality in patients with severe blunt trauma [11].…”