TRISS: Does It Get Better than This?

Abstract

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.

Risk stratification in trauma and haemorrhagic shock: Scoring systems derived from the TraumaRegister DGU®

“…However, the use of the TRISS had been critically discussed [8]. The TRISS is based on results from mostly American hospitals in the late 1980s and the German trauma care in part differs substantially from the American ones [25,33].…”

Use of Scene Vital Signs Improves TRISS Predicted Survival in Intubated Trauma Patients

“…The TRISS-calculated probability of survival takes into account the patient's age, RTS, ISS, mechanism of injury, and the appropriate coefficients. Although a comprehensive model, TRISS has been plagued by inadequacies in predicting survival for several groups of patients [1,2,[9][10][11]13]. Furthermore, this methodology has only been validated for use in nonparalyzed, nonintubated trauma patients.…”

“…TRISS combines several components (anatomical, physiological, mechanism) to determine a patient's probability of survival [1][2][3][4][5][6]. Physiological parameters are documented on admission to the hospital, and include Glasgow Coma Scale (GCS), respiratory rate (RR), and systolic blood pressure (SBP).…”

Development and validation of the revised injury severity classification score for severely injured patients

“…However, the use of the TRISS for the estimation of prognosis is also discussed critically [6]. Using the TRISS as a standard means, our own results are compared to the outcome of mostly American hospitals in the late 1980s.…”