Revised Trauma Score, Injury Severity Score, New Injury Severity Score and Trauma Revised Injury Severity Score among Trauma Patients in a Tertiary Care Hospital: A Comparative Study

Abstract

Introduction: Injury severity scoring can provide objective correlations with resource utilisation, such as length of stay and treatment costs, and inform clinical decisions regarding managing injuries of specific severity. The ability to predict survival after trauma is perhaps the most fundamental use of injury severity scoring. Aim: To compare the efficacy of the Injury Severity Score (ISS), Revised Trauma Score (RTS), New Injury Severity Score (NISS), and Trauma Revised Injury Severity Score (TRISS) in the prediction of mortality in trauma patients. Materials and Methods: In this comparative prospective observational study conducted in the Department of General Surgery, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India from April 2021 to September 2022 in 400 trauma patients who were clinically assessed and managed per the latest Advanced Trauma Life Support (ATLS) guidelines (10th edition). After the stabilisation of the patient, RTS, ISS, NISS and TRISS was obtained from the trauma chart, imaging studies and intraoperative findings. Statistical analysis was done using the statistical software Statistical Package for the Social Sciences (SPSS) version 16.0. Results: Most trauma patients showed more blunt injuries 284 (71.0%) than penetrating injuries 116 (29.0%). The major trauma region was external 161 (40.3%), followed by extremity 124 (31.0%). The mortality rate in this study was 17 (4.3%). The cut-off points for predicting mortality in trauma patients in ISS, RTS, NISS and TRISS systems were 22, 6.8, 28.5, 87.95 with sensitivity of 94.12%, 88.24%, 88.24%, 100.00% and specificity of 94.78%, 94.52%, 92.95%, 95.56%, respectively. Conclusion: According to the current study’s findings, TRISS was a more accurate prognosticator among trauma patients.

Keywords

• anatomical
• mortality rate
• physiological
• prognosticator
• receiver operating curve