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Erschienen in: European Journal of Trauma and Emergency Surgery 4/2020

08.12.2018 | Original Article

Predictive capability of the injury severity score versus the new injury severity score in the categorization of the severity of trauma patients: a cross-sectional observational study

verfasst von: Rebeca Abajas Bustillo, Francisco José Amo Setién, María del Carmen Ortego Mate, María Seguí Gómez, María Jesús Durá Ros, César Leal Costa

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2020

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Abstract

Purpose

The AIS scale is a measurement tool for single injuries. The ISS is considered the gold standard for determining the severity of injured patients, and the NISS was developed to improve the ISS with respect to loss of information, as well as to facilitate its calculation. The aim of this study was to analyse what injury severity measure, calculated according to the Abbreviated Injury Scale (AIS), 1998 and 2005 (update 2008) versions, performs better with mortality, cost and hospital length of stay healthcare indicators.

Methods

This cross-sectional observational study was carried out between February 1st 2012 and February 1st 2013. Inclusion criteria were injured patients due to external causes admitted to trauma service through the emergency department. Manual coding of all injuries was performed and ISS and NISS scores were calculated for both versions of the AIS scale. Severity was then compared to mortality (in-hospital and at 30 days), healthcare cost, and length of hospital stay.

Results

The index with the best predictive capability for in-hospital mortality was NISS 05 (AUC = 0.811). There was a significant increase in hospital stay and healthcare cost in the most severe patients in all indexes, except for ISS 05.

Conclusions

NISS is found to be an index with higher predictive capability for in-hospital mortality and correlates better to length of hospital stay and healthcare cost.
Literatur
1.
Zurück zum Zitat Association for the Advancement for Automotive Medicine. Escala de Lesiones Abreviada 2005. Actualización 2008. Ed. Des Plaines: AAAM; 2008. Association for the Advancement for Automotive Medicine. Escala de Lesiones Abreviada 2005. Actualización 2008. Ed. Des Plaines: AAAM; 2008.
2.
Zurück zum Zitat Salottolo K, Settell A, Uribe P, Akin S, Slone DS, O’Neal E, et al. The impact of the AIS 2005 revision on injury severity scores and clinical outcome measures. Injury. 2009;40(9):99–1003.CrossRef Salottolo K, Settell A, Uribe P, Akin S, Slone DS, O’Neal E, et al. The impact of the AIS 2005 revision on injury severity scores and clinical outcome measures. Injury. 2009;40(9):99–1003.CrossRef
3.
Zurück zum Zitat Leth PM, Ibsen M. Abbreviated injury scale scoring in traffic fatalities: comparison of computerized tomography and autopsy. J Trauma. 2010 Jun;68(6):1413–6.PubMedCrossRef Leth PM, Ibsen M. Abbreviated injury scale scoring in traffic fatalities: comparison of computerized tomography and autopsy. J Trauma. 2010 Jun;68(6):1413–6.PubMedCrossRef
4.
Zurück zum Zitat Baker SP, O’neill B, Haddon W, Long WB. The injury severity score: development and potential usefulness. Proc Am Assoc Automot Med Annu Conf. 1974;18:58–74. Baker SP, O’neill B, Haddon W, Long WB. The injury severity score: development and potential usefulness. Proc Am Assoc Automot Med Annu Conf. 1974;18:58–74.
5.
Zurück zum Zitat Osler T, Baker SP, Long W. A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma Acute Care Surg. 1997;43(6):922–6.CrossRef Osler T, Baker SP, Long W. A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma Acute Care Surg. 1997;43(6):922–6.CrossRef
6.
Zurück zum Zitat Association for the Advancement for Automotive Medicine. The abbreviated injury scale. Revision 1990. Ed. Des Plaines: AAAM; 1990. Association for the Advancement for Automotive Medicine. The abbreviated injury scale. Revision 1990. Ed. Des Plaines: AAAM; 1990.
7.
Zurück zum Zitat Association for the Advancement for Automotive Medicine. The abbreviated injury scale. Revision 1990. Update 1998. Ed. Des Plaines: AAAM; 1998. Association for the Advancement for Automotive Medicine. The abbreviated injury scale. Revision 1990. Update 1998. Ed. Des Plaines: AAAM; 1998.
8.
Zurück zum Zitat Lavoie A, Moore L, LeSage N, Liberman M, Sampalis JS. The new Injury Severity Score: a more accurate predictor of in-hospital mortality than the Injury Severity Score. J Trauma Acute Care Surg. 2004;56(6):1312–20.CrossRef Lavoie A, Moore L, LeSage N, Liberman M, Sampalis JS. The new Injury Severity Score: a more accurate predictor of in-hospital mortality than the Injury Severity Score. J Trauma Acute Care Surg. 2004;56(6):1312–20.CrossRef
9.
Zurück zum Zitat Haider AH, Villegas CV, Saleem T, Efron DT, Stevens KA, Oyetunji TA, et al. Should the IDC-9 trauma mortality prediction model become the new paradigm for benchmarking trauma outcomes? J Trauma Acute Care Surg. 2012 72(6):1695–701.PubMedCrossRef Haider AH, Villegas CV, Saleem T, Efron DT, Stevens KA, Oyetunji TA, et al. Should the IDC-9 trauma mortality prediction model become the new paradigm for benchmarking trauma outcomes? J Trauma Acute Care Surg. 2012 72(6):1695–701.PubMedCrossRef
10.
Zurück zum Zitat Nogueira L, Domingues C, Campos M, Sousa R. Ten years of new injury severity score (NISS): is it a possible change? Rev Lat Am. 2008;16(2):314–9.CrossRef Nogueira L, Domingues C, Campos M, Sousa R. Ten years of new injury severity score (NISS): is it a possible change? Rev Lat Am. 2008;16(2):314–9.CrossRef
11.
Zurück zum Zitat Van Belleghem G, Devos S, De Wit L, Hubloue I, Lauwaert D, Pien K, et al. Predicting in-hospital mortality of traffic victims: a comparison between AIS-and ICD-9-CM-related injury severity scales when only ICD-9-CM is reported. Injury. 2016;47(1):141–6.PubMedCrossRef Van Belleghem G, Devos S, De Wit L, Hubloue I, Lauwaert D, Pien K, et al. Predicting in-hospital mortality of traffic victims: a comparison between AIS-and ICD-9-CM-related injury severity scales when only ICD-9-CM is reported. Injury. 2016;47(1):141–6.PubMedCrossRef
13.
Zurück zum Zitat European Commission, Directorate-General for Internal Market, Industry, Entrepreneurship and SMEs. Report from the Commission to the European Parliament and The Council Saving Lives. Boosting Car Safety in the EU Reporting on the monitoring and assessment of advanced vehicle safety features, their cost effectiveness and feasibility for the review of the regulations on general vehicle safety and on the protection of pedestrians and other vulnerable road users. 2016; COM/2016/0787 final. European Commission, Directorate-General for Internal Market, Industry, Entrepreneurship and SMEs. Report from the Commission to the European Parliament and The Council Saving Lives. Boosting Car Safety in the EU Reporting on the monitoring and assessment of advanced vehicle safety features, their cost effectiveness and feasibility for the review of the regulations on general vehicle safety and on the protection of pedestrians and other vulnerable road users. 2016; COM/2016/0787 final.
14.
Zurück zum Zitat Abajas R, Leal C, Ortego MC, Zonfrillo M, Seguí M, Durá M. Grado de correlación entre las versiones 98 y 2005 (actualización 2008) de la Abbreviated Injury Scale (AIS) en la categorización del paciente traumatológico grave. Emergencias. 2018;30:41–4. Abajas R, Leal C, Ortego MC, Zonfrillo M, Seguí M, Durá M. Grado de correlación entre las versiones 98 y 2005 (actualización 2008) de la Abbreviated Injury Scale (AIS) en la categorización del paciente traumatológico grave. Emergencias. 2018;30:41–4.
15.
Zurück zum Zitat Copes W, Champion H, Sacco W, Lawnick M, Keast S, Bain L. The injury severity score revisited. J Trauma Acute Care Surg. 1988;28(1):69–77.CrossRef Copes W, Champion H, Sacco W, Lawnick M, Keast S, Bain L. The injury severity score revisited. J Trauma Acute Care Surg. 1988;28(1):69–77.CrossRef
16.
Zurück zum Zitat Stewart KE, Cowan LD, Thompson DM. Changing to AIS 2005 and agreement of injury severity scores in a trauma registry with scores based on manual chart review. Injury. 2011;42(9):934–9.PubMedCrossRef Stewart KE, Cowan LD, Thompson DM. Changing to AIS 2005 and agreement of injury severity scores in a trauma registry with scores based on manual chart review. Injury. 2011;42(9):934–9.PubMedCrossRef
17.
Zurück zum Zitat Lemeshow S, Hosmer Jr DW. A review of goodness of fit statistics for use in the development of logistic regression models. Am J Epidemiol. 1982;115(1):92–106.PubMedCrossRef Lemeshow S, Hosmer Jr DW. A review of goodness of fit statistics for use in the development of logistic regression models. Am J Epidemiol. 1982;115(1):92–106.PubMedCrossRef
18.
Zurück zum Zitat Gorra AS, Clark DE, Mullins RJ. Using hospital outcomes to predict 30-day mortality among injured patients insured by Medicare. Arch Surg. 2011;146(2):195–200.PubMedCrossRef Gorra AS, Clark DE, Mullins RJ. Using hospital outcomes to predict 30-day mortality among injured patients insured by Medicare. Arch Surg. 2011;146(2):195–200.PubMedCrossRef
19.
Zurück zum Zitat Mullins RJ, Mann NC, Hedges JR, Worrall W, Helfand M, Zechnich AD, et al. Adequacy of hospital discharge status as a measure of outcome among injured patients. JAMA. 1998;279(21):1727–31.PubMedCrossRef Mullins RJ, Mann NC, Hedges JR, Worrall W, Helfand M, Zechnich AD, et al. Adequacy of hospital discharge status as a measure of outcome among injured patients. JAMA. 1998;279(21):1727–31.PubMedCrossRef
20.
Zurück zum Zitat Clark DE, DeLorenzo MA, Lucas F, Wennberg DE. Epidemiology and short-term outcomes of injured medicare patients. J Am Geriatr Soc. 2004;52(12):2023–30.PubMedCrossRef Clark DE, DeLorenzo MA, Lucas F, Wennberg DE. Epidemiology and short-term outcomes of injured medicare patients. J Am Geriatr Soc. 2004;52(12):2023–30.PubMedCrossRef
21.
Zurück zum Zitat Pérez K, Cirera E, Plaséncia A. Estudio de la Mortalidad a 30 días por Accidentes de Tráfico (EMAT-30). Ministerio de Sanidad y Consumo ed.: Ministerio de Sanidad y Consumo; 2004. Pérez K, Cirera E, Plaséncia A. Estudio de la Mortalidad a 30 días por Accidentes de Tráfico (EMAT-30). Ministerio de Sanidad y Consumo ed.: Ministerio de Sanidad y Consumo; 2004.
22.
Zurück zum Zitat Tohira H, Jacobs I, Mountain D, Gibson N, Yeo A. Systematic review of predictive performance of injury severity scoring tools. Scand J Trauma Resusc Emerg Med. 2012;20(1):63.PubMedPubMedCentralCrossRef Tohira H, Jacobs I, Mountain D, Gibson N, Yeo A. Systematic review of predictive performance of injury severity scoring tools. Scand J Trauma Resusc Emerg Med. 2012;20(1):63.PubMedPubMedCentralCrossRef
23.
Zurück zum Zitat Ringdal KG, Coats TJ, Lefering R, Di Bartolomeo S, Steen PA, Røise O, et al. The Utstein template for uniform reporting of data following major trauma: a joint revision by SCANTEM, TARN, DGU-TR and RITG. Scand J Trauma Resusc Emerg Med. 2008;16(1):7.PubMedPubMedCentralCrossRef Ringdal KG, Coats TJ, Lefering R, Di Bartolomeo S, Steen PA, Røise O, et al. The Utstein template for uniform reporting of data following major trauma: a joint revision by SCANTEM, TARN, DGU-TR and RITG. Scand J Trauma Resusc Emerg Med. 2008;16(1):7.PubMedPubMedCentralCrossRef
24.
Zurück zum Zitat Balogh ZJ, Varga E, Tomka J, Süveges G, Tóth L, Simonka JA. The new injury severity score is a better predictor of extended hospitalization and intensive care unit admission than the injury severity score in patients with multiple orthopaedic injuries. J Orthop Trauma. 2003;17(7):508–12.PubMedCrossRef Balogh ZJ, Varga E, Tomka J, Süveges G, Tóth L, Simonka JA. The new injury severity score is a better predictor of extended hospitalization and intensive care unit admission than the injury severity score in patients with multiple orthopaedic injuries. J Orthop Trauma. 2003;17(7):508–12.PubMedCrossRef
25.
Zurück zum Zitat Tohira H, Jacobs I, Matsuoka T, Ishikawa K. Impact of the version of the abbreviated injury scale on injury severity characterization and quality assessment of trauma care. J Trauma. 2011;71(1):56–62.PubMedCrossRef Tohira H, Jacobs I, Matsuoka T, Ishikawa K. Impact of the version of the abbreviated injury scale on injury severity characterization and quality assessment of trauma care. J Trauma. 2011;71(1):56–62.PubMedCrossRef
26.
Zurück zum Zitat Zhao X, Zhang M, Gan J, Xu S, Jiang G. Comparison of the new injury severity score and the injury severity score in multiple trauma patients. Chin J Traumatol (English Edition). 2008;11(6):368–71.CrossRef Zhao X, Zhang M, Gan J, Xu S, Jiang G. Comparison of the new injury severity score and the injury severity score in multiple trauma patients. Chin J Traumatol (English Edition). 2008;11(6):368–71.CrossRef
27.
Zurück zum Zitat Aharonson-Daniel L, Giveon A, Stein M, Israel Trauma Group (ITG), Peleg K. Different AIS triplets: different mortality predictions in identical ISS and NISS. J Trauma. 2006;61(3):711–7.PubMedCrossRef Aharonson-Daniel L, Giveon A, Stein M, Israel Trauma Group (ITG), Peleg K. Different AIS triplets: different mortality predictions in identical ISS and NISS. J Trauma. 2006;61(3):711–7.PubMedCrossRef
28.
Zurück zum Zitat Rutledge R. The injury severity score is unable to differentiate between poor care and severe injury. J Trauma Acute Care Surg. 1996;40(6):944–50.CrossRef Rutledge R. The injury severity score is unable to differentiate between poor care and severe injury. J Trauma Acute Care Surg. 1996;40(6):944–50.CrossRef
Metadaten
Titel
Predictive capability of the injury severity score versus the new injury severity score in the categorization of the severity of trauma patients: a cross-sectional observational study
verfasst von
Rebeca Abajas Bustillo
Francisco José Amo Setién
María del Carmen Ortego Mate
María Seguí Gómez
María Jesús Durá Ros
César Leal Costa
Publikationsdatum
08.12.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 4/2020
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-018-1057-x

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