Journal of Trauma and Injury

  • 제18권2호
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  • Pages.141-147
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  • 2005
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

Modified TRISS: 둔상에 의한 두경부 외상 환자에서 개선된 병원 내 사망률 예측 방법

Modified TRISS: A More Accurate Predictor of In-hospital Mortality of Patients with Blunt Head and Neck Trauma

  • 김동훈 (경상대학교 의과대학 응급의학교실) ;
  • 박인성 (경상대학교 의과대학 응급의학교실)
  • Kim, Dong Hoon (Department of Emergency Medicine, Gyeongsang National University) ;
  • Park, In Sung (Department of Emergency Medicine, Gyeongsang National University)
  • 투고 : 2005.11.02
  • 심사 : 2005.12.07
  • 발행 : 2005.12.30
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초록

Purpose: Recently, The new Injury Severity Score (NISS) has become a more accurate predictor of mortality than the traditional Injury Severity Score (ISS) in the trauma population. Trauma Score Injury Severity Score (TRISS) method, regarded as the gold standard for mortality prediction in trauma patients, still contains the ISS as an essential factor within its formula. The purpose of this study was to determine whether a simple modification of the TRISS by replacing the ISS with the NISS would improve the prediction of in-hospital mortality in a trauma population with blunt head and neck trauma. Objects and Methods: The study population consisted of 641 patients from a regional emergency medical center in Kyoungsangnam-do. Demographic data, clinical information, the final diagnosis, and the outcome for each patient were collected in a retrospective manner. the ISS, NISS, TRISS, and modified TRISS were calculated for each patients. The discrimination and the calibration of the ISS, NISS, modified TRISS and conventional TRISS models were compared using receiver operator characteristic (ROC) curves, areas under the ROC curve (AUC) and Hosmer-Lemeshow statistics. Results: The AUC of the ISS, NISS, modified TRISS, and conventional TRISS were 0.885, 0.941, 0.971, and 0.918 respectively. Statistical differences were found between the ISS and the NISS (p=0.008) and between the modified TRISS and the conventional TRISS (p=0.009). Hosmer-Lemeshow chi square values were 13.2, 2.3, 50.1, and 13.8, respectively; only the conventional TRISS failed to achieve the level of and an excellent calibration model (p<0.001). Conclusion: The modified TRISS is a more accurate predictor of in-hospital mortality than the conventional TRISS in a trauma population of blunt head and neck trauma.

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참고문헌

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