Different AIS Triplets: Different Mortality Predictions in Identical ISS and NISS

Aharonson‐Daniel, Limor; Giveon, Adi; Stein, Michael D.; Peleg, Kobi

doi:10.1097/01.ta.0000235294.32326.e6

Cited by 56 publications

(35 citation statements)

References 21 publications

(10 reference statements)

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“…Estimating the risk to life of injured patients is a key factor in setting priority for treatment and in quality control of treatment provided [19]. Mortality is related to at least four major variables: severity of the injury, host factors, quality of care, and time elapsed before definitive treatment.…”

Section: Discussionmentioning

confidence: 99%

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The prognostic importance of serum IL-1β, IL-6, IL-8 and TNF-α levels compared to trauma scoring systems for early mortality in children with blunt trauma

2007

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The purpose of the present study was to determine whether a correlation exits between the main trauma scoring systems and the activation of inflammatory cells and mediators such as interleukin-(IL-) 1beta, IL-6, IL-8 and tumor necrosis factor alpha (TNF-alpha) after trauma, and moreover to assess if any of these can be used to predict the outcome in patients under care at a trauma center. Forty-seven children (37 boys, 10 girls) presenting with blunt trauma, were evaluated by an analysis of the relationship between overall mortality and potential risk factors. Admission data, including serum IL-1beta, IL-6, IL-8, TNF-alpha, pediatric trauma score (PTS), and injury severity score (ISS), were collected and analyzed. In descriptive statistics for independent variables, some prognostic factors such as IL-8 (P = 0.04), and ISS (P = 0.004) were significant in their relationship to mortality. In the univariate statistical analysis some other risk factors such as IL-8 (P = 0.004), >20 TNF-alpha (P = 0.04), and ISS (P = 0.007) were significant in their relationship to mortality. The relative risk of developing mortality was higher than two for each of the following risk factors: >10 ages, >25 IL-6, 10-20 TNF-alpha, >20 TNF-alpha, PTS 15. There was a positive correlation between IL-8 (r = 0.31, P = 0.33), ISS (r = 0.31, P = 0.0001), and mortality. There was also a correlation with ISS and IL-8 (r = 0.32, P = 0.02). ISS, and the serum IL-8 level are the most important determinants of clinical outcome in critically injured patients. A correlation exits between IL-8 and mortality and between ISS and IL-8.

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Section: Discussionmentioning

confidence: 99%

“…The ISS is widely used in trauma research to describe the severity of injury. In fact, it is well known that the ISS score is not useful as a triage tool and is known to be associated with risk of dying from injury [19]. The separation of ISS between 15 or less for minor trauma and 16 or more for major trauma was proposed as criteria [3].…”

Section: Discussionmentioning

confidence: 99%

The prognostic importance of serum IL-1β, IL-6, IL-8 and TNF-α levels compared to trauma scoring systems for early mortality in children with blunt trauma

2007

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“…The AIS triplets that produce identical ISS and NISS scores have markedly different mortality rates. [16][17][18] Because our study patients were too few in number, we borrowed the data of Kilgo et al [17] to carry out the analysis. For instance, an ISS of 27 is possible in two groups of patients where (5, 1, 1) had a 35.25% mortality rate in comparison with 11.31% in (3, 3, 3), representing a 23.94% difference in mortality, even though their ISS scores are identical.…”

Section: Discussionmentioning

confidence: 99%

“…[14,15] The present findings may help to shed some light on the statistical advantage of the ICISS over the ISS/NSS. Some studies [16][17][18] found that the mortality associated with AIS severity combinations that produce identical ISS/NISS is different. ISS/NISS scores with a higher AIS value significantly increased the risk of mortality.…”

Section: Methodsmentioning

confidence: 99%

The Natural Logarithm Transforms the Abbreviated Injury Scale That Improves Accuracy Scoring

Wang¹,

Gu²,

Zhang³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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RESULTSWe found that LISS is more predictive of survival as well (Hangzhou: receiver operating characteristic (ROC): NISS=0.931, LISS=0.949, p=0.006; Similarly, Zhejiang and Shenyang: ROC NISS vs. LISS, p<0.05). Moreover, LISS provides a better fit throughout its entire range of predicting (Hosmer-Lemeshow statistic for Hangzhou NISS=15.76, p=0.027; LISS=13.79, p=0.055; Similarly, for Zhejiang and Shenyang). CONCLUSIONLISS should be used as the standard summary measure of human trauma.

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“…Despite the numerous advantages of the ISS, it has some limitations [19,20]. The most obvious limitation is its inability to account for multiple injuries to the same body region; therefore, the ISS scale is rarely used to assess the severity of injury in victims of FFH with combined injuries of the abdominal organs.…”

Section: Introductionmentioning

confidence: 99%

Objective Assessment of the Severity of Patients Suffering from Fall from Height with Combined Injuries of the Abdominal Parenchymal Organs

Khadjibaev¹,

Sultanov²

2015

Int J Biomed

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In recent years, fall from a height (FFH) has been a relatively frequent cause of injury and death in the urban environment. The purpose of this study was to optimize the risk stratification of FFH victims with combined injuries of the abdominal organs by using Injury Severity Score (ISS) scale. The study included 111 patients (aged between 15 and 80 years) injured by FFH. All the falls were accidental and occurred mainly among males (82%). The height of the fall ranged from 2 to 5 meters. Combined injuries were found in 98 patients and isolated injuries in 13 patients. The combination of the 6 injured body regions was identified in 5 patients, 5 regions in 17, 4 in 35, 3 in 23, and 2 in 18. The abdomen trauma was most commonly associated with the following injured body regions: head and neck-chest-extremities and pelvis (13.3%), head and neck-chest-extremities (12.2%), and head and neck-chest-pelvis (9.2%). Among the combined injuries of the abdomen, ruptures of parenchymal organs (liver, spleen and kidneys) were predominant. To assess the severity of the injury, the ISS scale was applied. The injuries of abdominal parenchymal organs were evaluated according to the AAST (American Association for the Surgery of Trauma) classification. Comparative analysis of the assessment of the severity of a patient's condition according to the traditional scale and the ISS scale showed that the ISS scale promotes the active and timely detection of the extremely severe and terminal condition in patients with injuries due to FFH with combined trauma of the abdominal organs. Objective assessment of the severity of trauma and the dominant injury region allows determining the optimal treatment algorithm and predicting the outcome of the injury.

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Different AIS Triplets: Different Mortality Predictions in Identical ISS and NISS

Cited by 56 publications

References 21 publications

The prognostic importance of serum IL-1β, IL-6, IL-8 and TNF-α levels compared to trauma scoring systems for early mortality in children with blunt trauma

The prognostic importance of serum IL-1β, IL-6, IL-8 and TNF-α levels compared to trauma scoring systems for early mortality in children with blunt trauma

The Natural Logarithm Transforms the Abbreviated Injury Scale That Improves Accuracy Scoring

Objective Assessment of the Severity of Patients Suffering from Fall from Height with Combined Injuries of the Abdominal Parenchymal Organs

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