Korean J Crit Care Med.  2016 Aug;31(3):221-228. 10.4266/kjccm.2016.00486.

The Best Prediction Model for Trauma Outcomes of the Current Korean Population: a Comparative Study of Three Injury Severity Scoring Systems

• Jung K
• Lee JC
• Park RW
• Yoon D
• Jung S
• Kim Y
• Moon J
• Huh Y
• Kwon J

• KMID: 2350906
• DOI: http://doi.org/10.4266/kjccm.2016.00486

Abstract

BACKGROUND
Injury severity scoring systems that quantify and predict trauma outcomes have not been established in Korea. This study was designed to determine the best system for use in the Korean trauma population.
METHODS
We collected and analyzed the data from trauma patients admitted to our institution from January 2010 to December 2014. Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) were calculated based on the data from the enrolled patients. Area under the receiver operating characteristic (ROC) curve (AUC) for the prediction ability of each scoring system was obtained, and a pairwise comparison of ROC curves was performed. Additionally, the cut-off values were estimated to predict mortality, and the corresponding accuracy, positive predictive value, and negative predictive value were obtained.
RESULTS
A total of 7,120 trauma patients (6,668 blunt and 452 penetrating injuries) were enrolled in this study. The AUCs of ISS, RTS, and TRISS were 0.866, 0.894, and 0.942, respectively, and the prediction ability of the TRISS was significantly better than the others (p < 0.001, respectively). The cut-off value of the TRISS was 0.9082, with a sensitivity of 81.9% and specificity of 92.0%; mortality was predicted with an accuracy of 91.2%; its positive predictive value was the highest at 46.8%.
CONCLUSIONS
The results of our study were based on the data from one institution and suggest that the TRISS is the best prediction model of trauma outcomes in the current Korean population. Further study is needed with more data from multiple centers in Korea.

Keyword

Korea; injury severity score; mortality; prediction; trauma centers; outcomes

MeSH Terms

Area Under Curve
Humans
Injury Severity Score
Korea
Mortality
ROC Curve
Sensitivity and Specificity
Trauma Centers

Figure

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  Fig. 1. Receiver operating characteristic curves of Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) for predicting mortality in the study population.

Reference

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