. 2008; 14(4): 308-312 | |||
Should New Injury Severity Score Replace Injury Severity Score in Trauma and Injury Severity Score ?Şule Akköse Aydın1, Mehtap Bulut2, Halil Özgüç3, İlker Ercan4, Nursel Türkmen5, Bülent Eren6, Mehmet Esen71Sule Akkose Department Of Emergency Medicine, Uludag University Medical School, Bursa, Turkey2Mehtap Bulut, Department Of Emergency Medicine 3Halil Ozguc, Department Of General Surgery 4Ilker Ercan, Department Of Biostatistic 5Nursel Turmen, Department Of Forensic Medicine 6Bulent Eren, Department Of Forensic Medicine 7Mehmet Esen, Department Of Emergency Medicine BACKGROUND: This study was performed to compare the efficacies of Injury Severity Score (ISS) and New Injury Severity Score (NISS), and to investigate whether replacing ISS with NISS in Trauma and Injury Severity Score (TRISS) changes the predictive power for mortality. METHODS: We retrospectively analyzed 550 patients aged over 16 years seen in our center over a period of four years who had injuries in at least two organ systems. The ISS, NISS and TRISS were calculated for each patient. TRISS was calculated in two ways: TRISS 1 with age, Revised Trauma Score (RTS) and ISS, and TRISS 2 with age, RTS and NISS. The cut-off values for TRISS 1, TRISS 2, ISS and NISS were determined by ROC analysis. RESULTS: The ideal cut-off values for the prediction of mortality were 21.0 (AUC: 0.907) for ISS and 25.0 (AUC: 0.914) for NISS. There was no statistically significant difference between the ROC curves of ISS and NISS. The ideal cut-off values for predicting mortality were 90 (AUC: 0.934) for TRISS 1 and 86 (AUC: 0.935) for TRISS 2. There was no statistically significant difference between the ROC curves of TRISS 1 and TRISS 2. CONCLUSION: Use of NISS instead of ISS in the TRISS model demonstrated no significant difference, and it can thus be recommended for use. Keywords: Injury Severity Score, New Injury Severity Score; Trauma and Injury Severity Score.Should the New Injury Severity Score replace the Injury Severity Score in the Trauma and Injury Severity Score?Şule Akköse Aydın1, Mehtap Bulut2, Halil Özgüç3, İlker Ercan4, Nursel Türkmen5, Bülent Eren6, Mehmet Esen71Sule Akkose, Uludağ Üniversitesi Tıp Fakültesi Acil Tıp AD, Bursa2Mehtap Bulut, Uludağ Üniversitesi Tıp Fakültesi Acil Tıp AD 3Halil Özgüç, Uludağ Üniversitesi Tıp Fakültesi Genel Cerrahi AD 4İlker Ercan, Uludağ Üniversitesi Tıp Fakültesi Biyoistatistik AD 5Nursel Türkmen, Uludağ Üniversitesi Tıp Fakültesi Adli Tıp AD 6Bülent Eren, Uludağ Üniversitesi Tıp Fakültesi Adli Tıp AD 7Mehmet Esen, Uludağ Üniversitesi Tıp Fakültesi Acil Tıp AD AMAÇ: Bu çalışmada, çoklu travmalı olgularda mortalitenin öngörülmesinde hem Yaralanma Şiddeti Ölçeği (ISS) ile Yeni Yaralanma Şiddeti Ölçeği (NISS) etkinliği karşılaştırıldı, hem de “Travma ve Yaralanma Şiddeti Ölçeği’nde (TRISS) ISS’nin yerini NISS alabilir mi?” sorusuna cevaplar arandı. GEREÇ-YÖNTEM: En az iki organ sistemi yaralanması olan 16 yaş üstü 550 travma olgusunun Revize Edilmiş Travma Skoru (RTS), ISS ve NISS’leri saptandı. Bu olguların TRISS’leri önce önerilen yönteme göre; ISS, RTS, yaş parametreleriyle (TRISS 1) sonra NISS, RTS ve yaş parametreleriyle (TRISS 2) hesaplandı. Her skorun cut-off değerleri ROC analizi ile belirlendi. Belirlenen cut-off değerlerine göre sınıflanan travma skorları, diğer olası risk faktörleriyle birlikte lojistik regresyon analizine konuldu ve mortaliteyi etkilemedeki risk düzeyi araştırıldı. Şule Akköse Aydın, Mehtap Bulut, Halil Özgüç, İlker Ercan, Nursel Türkmen, Bülent Eren, Mehmet Esen. Should New Injury Severity Score Replace Injury Severity Score in Trauma and Injury Severity Score ?. . 2008; 14(4): 308-312 Corresponding Author: Şule Akköse Aydın, Türkiye |
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