DOI QR코드

DOI QR Code

Evaluation of Probability of Survival Using Trauma and Injury Severity Score Method in Severe Neurotrauma Patients

  • Moon, Jung-Ho (Department of Neurosurgery, Chonnam National University Hospital & Medical School) ;
  • Seo, Bo-Ra (Department of Neurosurgery, Mokpo Hankook Hospital) ;
  • Jang, Jae-Won (Department of Neurosurgery, Chonnam National University Hospital & Medical School) ;
  • Lee, Jung-Kil (Department of Neurosurgery, Chonnam National University Hospital & Medical School) ;
  • Moon, Hyung-Sik (Department of Neurosurgery, Mokpo Hankook Hospital)
  • 투고 : 2013.01.31
  • 심사 : 2013.07.17
  • 발행 : 2013.07.28

초록

Objective : Despite several limitations, the Trauma Injury Severity Score (TRISS) is normally used to evaluate trauma systems. The aim of this study was to evaluate the preventable trauma death rate using the TRISS method in severe trauma patients with traumatic brain injury using our emergency department data. Methods : The use of the TRISS formula has been suggested to consider definitively preventable death (DP); the deaths occurred with a probability of survival (Ps) higher than 0.50 and possible preventable death (PP); the deaths occurred with a Ps between 0.50 and 0.25. Deaths in patients with a calculated Ps of less than 0.25 is considered as non-preventable death (NP). A retrospective case review of deaths attributed to mechanical trauma occurring between January 1, 2011 and December 31, 2011 was conducted. Results : A total of 565 consecutive severe trauma patients with ISS>15 or Revised Trauma Score<7 were admitted in our institute. We excluded a total of 24 patients from our analysis : 22 patients younger than 15 years, and 2 patients with burned injury. Of these, 221 patients with head injury were analyzed in the final study. One hundred eighty-two patients were in DP, 13 in PP and 24 in NP. The calculated predicted mortality rates were 11.13%, 59.04%, and 90.09%. The actual mortality rates were 12.64%, 61.547%, and 91.67%, respectively. Conclusion : Although it needs to make some improvements, the present study showed that TRISS performed well in predicting survival of traumatic brain injured patients. Also, TRISS is relatively exact and acceptable compared with actual data, as a simple and time-saving method.

키워드

참고문헌

  1. Barmparas G, Singer M, Ley E, Chung R, Malinoski D, Margulies D, et al. : Decreased intracranial pressure monitor use at level II trauma centers is associated with increased mortality. Am Surg 78 : 1166-1171, 2012
  2. Cayten CG, Stahl WM, Murphy JG, Agarwal N, Byrne DW : Limitations of the TRISS method for interhospital comparisons : a multihospital study. J Trauma 31 : 471-481; discussion 481-482, 1991 https://doi.org/10.1097/00005373-199104000-00005
  3. Champion HR, Copes WS, Sacco WJ, Frey CF, Holcroft JW, Hoyt DB, et al. : Improved predictions from a severity characterization of trauma (ASCOT) over Trauma and Injury Severity Score (TRISS) : results of an independent evaluation. J Trauma 40 : 42-48; discussion 48-49, 1996 https://doi.org/10.1097/00005373-199601000-00009
  4. Champion HR, Copes WS, Sacco WJ, Lawnick MM, Keast SL, Bain LW Jr, et al. : The Major Trauma Outcome Study : establishing national norms for trauma care. J Trauma 30 : 1356-1365, 1990 https://doi.org/10.1097/00005373-199011000-00008
  5. Chiara O, Cimbanassi S, Pitidis A, Vesconi S : Preventable trauma deaths : from panel review to population based-studies. World J Emerg Surg 1 : 12, 2006 https://doi.org/10.1186/1749-7922-1-12
  6. Copes WS, Champion HR, Sacco WJ, Lawnick MM, Keast SL, Bain LW : The Injury Severity Score revisited. J Trauma 28 : 69-77, 1988 https://doi.org/10.1097/00005373-198801000-00010
  7. Gabbe BJ, Cameron PA, Wolfe R : TRISS : does it get better than this? Acad Emerg Med 11 : 181-186, 2004 https://doi.org/10.1111/j.1553-2712.2004.tb01432.x
  8. Hannan EL, Mendeloff J, Farrell LS, Cayten CG, Murphy JG : Validation of TRISS and ASCOT using a non-MTOS trauma registry. J Trauma 38 : 83-88, 1995 https://doi.org/10.1097/00005373-199501000-00022
  9. Kilgo PD, Meredith JW, Hensberry R, Osler TM : A note on the disjointed nature of the injury severity score. J Trauma 57 : 479-485; discussion 486-487, 2004 https://doi.org/10.1097/01.TA.0000141024.96440.7C
  10. Kilgo PD, Meredith JW, Osler TM : Incorporating recent advances to make the TRISS approach universally available. J Trauma 60 : 1002-1008; discussion 1008-1009, 2006 https://doi.org/10.1097/01.ta.0000215827.54546.01
  11. Kim JJ, Gean AD : Imaging for the diagnosis and management of traumatic brain injury. Neurotherapeutics 8 : 39-53, 2011 https://doi.org/10.1007/s13311-010-0003-3
  12. Kirkham JJ : A comparison of hospital performance with non-ignorable missing covariates : an application to trauma care data. Stat Med 27 : 5725-5744, 2008 https://doi.org/10.1002/sim.3379
  13. Millham FH, LaMorte WW : Factors associated with mortality in trauma : re-evaluation of the TRISS method using the National Trauma Data Bank. J Trauma 56 : 1090-1096, 2004 https://doi.org/10.1097/01.TA.0000119689.81910.06
  14. Moore L, Lavoie A, Camden S, Le Sage N, Sampalis JS, Bergeron E, et al. : Statistical validation of the Glasgow Coma Score. J Trauma 60 : 1238-1243; discussion 1243-1244, 2006 https://doi.org/10.1097/01.ta.0000195593.60245.80
  15. Moore L, Lavoie A, LeSage N, Abdous B, Bergeron E, Liberman M, et al. : Statistical validation of the Revised Trauma Score. J Trauma 60 : 305-311, 2006 https://doi.org/10.1097/01.ta.0000200840.89685.b0
  16. Moore L, Lavoie A, Turgeon AF, Abdous B, Le Sage N, Emond M, et al. : Improving trauma mortality prediction modeling for blunt trauma. J Trauma 68 : 698-705, 2010 https://doi.org/10.1097/TA.0b013e3181aa093d
  17. Schluter PJ, Nathens A, Neal ML, Goble S, Cameron CM, Davey TM, et al. : Trauma and Injury Severity Score (TRISS) coefficients 2009 revision. J Trauma 68 : 761-770, 2010 https://doi.org/10.1097/TA.0b013e3181d3223b
  18. Trunkey DD : Trauma. Accidental and intentional injuries account for more years of life lost in the U.S. than cancer and heart disease. Among the prescribed remedies are improved preventive efforts, speedier surgery and further research. Sci Am 249 : 28-35, 1983 https://doi.org/10.1038/scientificamerican0883-28
  19. West TA, Rivara FP, Cummings P, Jurkovich GJ, Maier RV : Harborview assessment for risk of mortality : an improved measure of injury severity on the basis of ICD-9-CM. J Trauma 49 : 530-540; discussion 540-541, 2000 https://doi.org/10.1097/00005373-200009000-00022

피인용 문헌

  1. Pooled preventable death rates in trauma patients : Meta analysis and systematic review since 1990 vol.40, pp.3, 2013, https://doi.org/10.1007/s00068-013-0364-5
  2. Survival probability in patients with liver trauma vol.29, pp.7, 2013, https://doi.org/10.1108/ijhcqa-04-2016-0045
  3. Predictive Statistical Diagnosis to Determine the Probability of Survival in Adult Subjects with Traumatic Brain Injury vol.6, pp.2, 2013, https://doi.org/10.3390/technologies6020041
  4. Effect of Mannitol Infusion on Optic Nerve Injury After Acute Traumatic Subarachnoid Hemorrhage and Brain Injury vol.29, pp.7, 2013, https://doi.org/10.1097/scs.0000000000004827
  5. A Comparative Study of Injury Severity Scales as Predictors of Mortality in Trauma Patients: Which Scale Is the Best? vol.8, pp.1, 2020, https://doi.org/10.29252/beat-080105
  6. Machine Learning Algorithms to Predict In-Hospital Mortality in Patients with Traumatic Brain Injury vol.11, pp.11, 2013, https://doi.org/10.3390/jpm11111144