The Applicability of Trauma and Injury Severity Score for a Blunt Trauma Population in Korea and a Proposal of New Models Using Score Predictors.
10.3349/ymj.2016.57.3.728
- Author:
Kyoungwon JUNG
1
;
Yo HUH
;
John Cook Jong LEE
;
Younghwan KIM
;
Jonghwan MOON
;
Seok Hwa YOUN
;
Jiyoung KIM
;
Juryang KIM
;
Hyoju KIM
Author Information
1. Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea. jake98@daum.net
- Publication Type:Original Article
- Keywords:
Injury Severity Score;
Korea;
trauma;
trauma centers
- MeSH:
Adolescent;
Adult;
Aged;
Databases, Factual;
Female;
Humans;
*Injury Severity Score;
Logistic Models;
Male;
Middle Aged;
Predictive Value of Tests;
Probability;
Prognosis;
ROC Curve;
Republic of Korea;
Trauma Centers/statistics & numerical data;
*Trauma Severity Indices;
Wounds, Nonpenetrating/*diagnosis
- From:Yonsei Medical Journal
2016;57(3):728-734
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study was to verify the utility of existing Trauma and Injury Severity Score (TRISS) coefficients and to propose a new prediction model with a new set of TRISS coefficients or predictors. MATERIALS AND METHODS: Of the blunt adult trauma patients who were admitted to our hospital in 2014, those eligible for Korea Trauma Data Bank entry were selected to collect the TRISS predictors. The study data were input into the TRISS formula to obtain "probability of survival" values, which were examined for consistency with actual patient survival status. For TRISS coefficients, Major Trauma Outcome Study-derived values revised in 1995 and National Trauma Data Bank-derived and National Sample Project-derived coefficients revised in 2009 were used. Additionally, using a logistic regression method, a new set of coefficients was derived from our medical center's database. Areas under the receiver operating characteristic (ROC) curve (AUC) for each prediction ability were obtained, and a pairwise comparison of ROC curves was performed. RESULTS: In the statistical analysis, the AUCs (0.879-0.899) for predicting outcomes were lower than those of other countries. However, by adjusting the TRISS score using a continuous variable rather than a code for age, we were able to achieve higher AUCs [0.913 (95% confidence interval, 0.899 to 0.926)]. CONCLUSION: These results support further studies that will allow a more accurate prediction of prognosis for trauma patients. Furthermore, Korean TRISS coefficients or a new prediction model suited for Korea needs to be developed using a sufficiently sized sample.
