Trauma and Injury Severity Score (TRISS) in Head Injury Patients
Abstract
Background: Injury severity classifications have been developed for the past decades. Milestone study in the quest for the best possible method to predict outcomes of injured trauma patients has been studied continuously. Quantitative characterizations of injury are essential for research, meaningful evaluations of patient outcome, quality improvement, and prevention programs. Trauma and Injury Severity Score (TRISS) is a combination index based on then state-of-the-art severity indices, the Trauma Score (TI) and the Injury Severity Score (ISS), patient age, and mechanism of injury. Since its development, TRISS has been a frequently used method for predicting survival or mortality of trauma inpatients, but unfortunately not many studies had reported about using TRISS with neurotrauma cases.
Materials and Methods: A retrospective study to determine the accuracy of TRISS in head-injured patients was made by review of medical records of patients admitted between December 2000 and May 2001 to Trauma Unit of Saraburi Hospital were reviewed by trauma audit staffs consisting of various specialties such as general surgeons, neurosurgeons, urologists and plastic surgeons.
Results: The results of this study showed that there were man y drawbacks of using TRISS in predicting the death of neurotrauma patients. TRISS model did not work well in predicting survival for neurotrauma patient.
Conclusion: Because of the limitations of TRISS, peer reviews or other new models such as ICISS should supersede it. Some possible refinements such as the mechanisms of injury, timing of injury, nature of diseases, hospital charges, and the prognosis should be included in the models in predicting the neurotrauma outcome.
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