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KMID : 0385920200310060543
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Journal of the Korean Society of Emergency Medicine
2020 Volume.31 No. 6 p.543 ~ p.552
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Comparison of the new and conventional injury severity scoring systems for predicting mortality in severe geriatric trauma
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Ryu Ho-Wan
Ahn Jae-Yun
Seo Kang-Suk
Park Jung-Bae
Kim Jong-Kun
Lee Mi-Jin
Ryoo Hyun-Wook
Kim Yun-Jeong
Kim Chang-Ho
Choe Jae-Young
Lee Dong-Eun
Yeo In-Hwan
Moon Sung-Bae
Cho Yeon-Joo
Chung Han-Sol
Cho Jae-Wan
Jung Hae-Won
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Abstract
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Objective: This study compared the prognostic performance of the following five injury severity scores: the Geriatric Trauma Outcome Score (GTOS), the Injury Severity Score (ISS), the New Injury Severity Score (NISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS) for in-hospital mortality in severe geriatric trauma patients.
Method: A retrospective, cross-sectional, observational study was conducted using a database of severe geriatric trauma patients (age ≥65 years and ISS ≥16) who presented to a single regional trauma center between November 2016 and October 2018. We compared the baseline characteristics between the survivor and mortality groups and the predictive ability of the five scoring systems.
Results: A total of 402 patients were included in the analysis; the in-hospital mortality rate was 25.6% (n=103). The TRISS had the highest area under the curve of 0.953 (95% confidence interval [CI], 0.927-0.971); followed by RTS, 0.777 (95% CI, 0.733-0.817); NISS, 0.733 (95% CI, 0.687-0.776); ISS, 0.660 (95% CI, 0.612-0.707); and GTOS, 0.660 (95% CI, 0.611-0.706) in severe geriatric trauma. The TRISS also had the highest area under the curve of 0.961 (0.919-0.985) among the injury severity scoring systems in polytrauma. The predictive ability of TRISS was significantly higher than the other four scores with respect to overall trauma and polytrauma (P<0.001).
Conclusion: The TRISS showed the highest prognostic performance for predicting in-hospital mortality among all the injury severity scoring systems in severe geriatric trauma.
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KEYWORD
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Wounds and injuries, Assessment, Geriatric, Mortality, Prognosis
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