Validation of Trauma and Injury Severity Score in Blunt Trauma Patients by Using a Canadian Trauma Registry

Abstract

TRISS demonstrated satisfactory performance in a Canadian blunt trauma population. Although revision of coefficients led to a better fit on the Hosmer-Lemeshow statistic, ROC curves demonstrated virtually identical performance of the MTOS and Ontario-based TRISS models. The poor performance of the Revised Trauma Score and the observation that its use led to the exclusion of 40% of cases with a higher mortality raises concerns regarding its use in the TRISS model.

TRISS: Does It Get Better than This?

“…Most studies found that TRISS discriminates well between survivors and nonsurvivors but lacks predictive reliability. 8,[28][29][30] The question has been raised about whether it is more relevant and accurate to generate TRISS equation coefficients that are unique to particular trauma data sources, rather than relying on the originally published MTOS coefficients. The development of new TRISS coefficients for analysis of the outcomes of individual trauma data sets would seem logical because different regions, trauma centers, etc., are likely to differ in the casemix of patients seen, injury types, patient types, and severity of injuries seen.…”

“…[28][29][30] Although the coefficients developed by individual studies were quite different from the MTOS coefficients, the pattern of findings remains the same with marginally improved discrimination but generally poor predictive reliability.…”

Desempenho dos ajustes do Trauma and Injury Severity Score (TRISS): revisão integrativa

“…Table 1 shows predominance of retrospective (87.5%) (14)(15)(16)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45) national multi-center studies (62,5%) (18)(19)(20)(22)(23)(25)(26)(27)(28)(29)(30)(31)(32)(33)35,38,(41)(42)(44)(45) , using databases as sources (81.3%) (19)(20)(21)…”

Trauma and injury severity score: análise de novos ajustes no índice

“…(24,(68)(69)(70)(71)(72) . A maioria desses estudos foi desenvolvida e publicada nos EUA (11,37,39,41,43,(57)(58)(60)(61)(63)(64)(65)(66)(67)(68)(71)(72)(73)(74) , sendo, dessa forma, o inglês o idioma mais frequente de publicação (11,19,24,33,(35)(36)(37)(38)(39)(40)(41)(42)(43)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)…”

“…Houve predomínio de estudos que trabalharam com apenas uma equação modificada (43,8%) (11,24,(33)(34)38,(41)(42)58,60,(63)(64)(66)(67)72) , seguidos por 2 equações (18,8%) (37,61,62,71,73,74) . …”