The New Injury Severity Score: A More Accurate Predictor of In-Hospital Mortality than the Injury Severity Score

Lavoie, André; Moore, Lynne; LeSage, Natalie; Liberman, Moïshe; Sampalis, John S.

doi:10.1097/01.ta.0000075342.36072.ef

Cited by 180 publications

(177 citation statements)

References 17 publications

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“…[2,8,9] Several studies indicate that trauma-related deaths are usually divided into three groups. Group I (50%) enrolls those who die at the scene (usually patients with major head trauma or severe vascular injury).…”

Section: Discussionmentioning

confidence: 99%

“…Up to 30% of patients with trauma are intubated and sedated upon arrival to the Emergency Department. [2] Regardless of the accuracy of trauma scores, is based on an anatomical description of every injury and cannot be assigned to the patients until a full diagnostic procedure has been performed. [3] Many studies have revealed alteration in glucose metabolism in trauma and proportional relation of its high level to the degree of injury.…”

mentioning

confidence: 99%

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Venous glucose, serum lactate and base deficit as biochemical predictors of mortality in patients with polytrauma.

Saad¹

2015

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Venous glucose, serum lactate and base deficit as biochemical predictors of mortality in patients with polytrauma.

Saad¹

2015

Ulus Travma Acil Cerrahi Derg

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“…Most of the studies have observed better discrimination and calibration for the NISS, [6][7][8][9] and some studies have observed better calibration but equivalent discrimination. [10,11] In addition, a few studies have noted no advantage of the NISS.…”

Section: Methodsmentioning

confidence: 99%

The Natural Logarithm Transforms the Abbreviated Injury Scale That Improves Accuracy Scoring

Wang¹,

Gu²,

Zhang³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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RESULTSWe found that LISS is more predictive of survival as well (Hangzhou: receiver operating characteristic (ROC): NISS=0.931, LISS=0.949, p=0.006; Similarly, Zhejiang and Shenyang: ROC NISS vs. LISS, p<0.05). Moreover, LISS provides a better fit throughout its entire range of predicting (Hosmer-Lemeshow statistic for Hangzhou NISS=15.76, p=0.027; LISS=13.79, p=0.055; Similarly, for Zhejiang and Shenyang). CONCLUSIONLISS should be used as the standard summary measure of human trauma.

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“…Among the various methods for measuring injury severity, the New Injury Severity Score (NISS) has been considered a more predictable indicator and superior to the Injury Severity Score (ISS) for the analysis of mortality, multiple organ failure, and functional recovery from multiple trauma. [2][3][4] Despite its excellent performance, the NISS has not been widely used, perhaps because it is derived from the effort-intensive Abbreviated Injury Scale (AIS), which typically is recorded by an independent, qualified recorder. 5 The Barell matrix is another approach to gathering information related to injury severity from diagnostic codes.…”

mentioning

confidence: 99%

Development and Validation of the Excess Mortality Ratio–adjusted Injury Severity Score Using the International Classification of Diseases 10th Edition

Kim¹,

Shin

et al. 2009

Academic Emergency Medicine

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Objectives: This study aimed to develop and validate a new method for measuring injury severity, the excess mortality ratio-adjusted Injury Severity Score (EMR-ISS), using the International Classification of Diseases 10th Edition (ICD-10).Methods: An injury severity grade similar to the Abbreviated Injury Scale (AIS) was converted from the ICD-10 codes on the basis of quintiles of the EMR for each ICD-10 code. Like the New Injury Severity Score (NISS), the EMR-ISS was calculated from three maximum severity grades using data from the Korean National Injury Database. The EMR-ISS was then validated using the Hosmer-Lemeshow goodness-of-fit chi-square (HL chi-square, with lower values preferable), the area under the receiver operating characteristic curve (AUC-ROC), and the Pearson correlation coefficient to compare it with the International Classification of Diseases 9th Edition-based Injury Severity Score (ICISS). Nationwide hospital discharge abstract data (DAD) from stratified-sample general hospitals (n = 150) in 2004 were used for an external validation.Results: The total number of study subjects was 29,282,531, with five subgroups of particular interest identified for further study: traumatic brain injury (TBI, n = 3,768,670), traumatic chest injury (TCI, n = 1,169,828), poisoning (n = 251,565), burns (n = 869,020), and DAD (n = 26,374). The HL chi-square was lower for EMR-ISS than for ICISS in all groups: 42,410.8 versus 55,721.9 in total injury, 7,139.6 versus 20,653.9 in TBI,6,603.3 versus 4,531.8 Conclusions: The EMR-ISS showed better calibration and discrimination power for prediction of death than the ICISS in most injury groups. The EMR-ISS appears to be a feasible tool for passive injury surveillance of large data sets, such as insurance data sets or community injury registries containing diagnosis codes. Additional further studies for external validation on prospectively collected data sets should be considered.

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The New Injury Severity Score: A More Accurate Predictor of In-Hospital Mortality than the Injury Severity Score

Abstract: The NISS is a more accurate predictor of in-hospital death than the ISS and should be chosen over the ISS for case-mix control in trauma research, especially in certain subpopulations such as head/neck-injured patients.

Cited by 180 publications

References 17 publications

Venous glucose, serum lactate and base deficit as biochemical predictors of mortality in patients with polytrauma.

Venous glucose, serum lactate and base deficit as biochemical predictors of mortality in patients with polytrauma.

The Natural Logarithm Transforms the Abbreviated Injury Scale That Improves Accuracy Scoring

Development and Validation of the Excess Mortality Ratio–adjusted Injury Severity Score Using the International Classification of Diseases 10th Edition

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