Measuring injury severity: time for a change?

摘要: Background: The Injury Severity Score (ISS) does not take into account multiple injuries in the same body region, whereas a New ISS (NISS) may provide more accurate measure of trauma severity by considering patient's three greatest regardless region. purpose this study was to evaluate and NISS patients with blunt trauma. Methods: Consecutive individuals treated from January 1992 September 1996 at one institution were included if they had sustained satisfied triage standards (n = 2,328). For each patient, we computed determine how often two scores identical or discrepant. Discrepant cases then further analyzed using receiver operating characteristic curves which score better predicted short-term mortality. Results: mean 25 ± 13, 33 18. predictive 32% discrepant 68% patients. Patients lower mortality rate than (10% vs. 13%; p < 0.02). In scores, area under greater for (0.852 0.799; 0.001), amounts discrepancy associated increasing rates (p 0.001). Conclusions: increases apparent injury provides prediction benefit rather must be weighed against disadvantages changing scoring system potential still improvements.