Prognosis of the Trauma Patients According to the Trauma and Injury Severity Score (TRISS); A Diagnostic Accuracy Study

Abstract

<strong>Objective:</strong> To investigate the prognosis and survival rates of a group of Iranian patients with traumatic injuries using the trauma and injury severity score (TRISS) model.<br /> <strong>Methods:</strong> In this prospective cohort study, all the patients with multi-trauma referring to the Yasuj Shahid Beheshti hospital during 2018 were included. The patients' demographic information, trauma and history of previous illness were recorded. Vital symptoms including respiratory rate, heart rate, hypertension, pulse rate and Glasgow coma scale (GCS) score were assessed. The injury severity score (ISS) was calculated based on the type and location of the injuries and according to the abbreviated injury scale (AIS) classification. The survival probability of the patients was assessed according to the TRISS model.<br /> <strong>Results:</strong> Overall, 252 trauma patients were evaluated out of whom, 195 (77.4%) were men and 57 (22.6%) women. The mean TRISS score was 24.2 ± 9.32 and the maximum score was 99.7. If we consider the TRISS score probability above 0.5 as the chance of being alive, the mortality rate was 6.75%, that was lower than our series (7.1%). The ISS score and GCS had a positive significant relationship with other variables except respiratory rate, body temperature and hospitalization. Revised trauma score (RTS) was significantly associated with other variables including age, GCS, hemoglobin, systolic blood pressure and respiratory rate. TRISS had an area under curve (AUC) of 0.988 indicating a high prognostic accuracy.<br /> <strong>Conclusion:</strong> The mortality rate was lower than that of being predicted by TRISS. This might be due to treatment effectiveness and care for traumatic patients leading to decreased mortality. TRISS had high prognostic accuracy in trauma patients. We also reported an association between hemoglobin and survival rate. Therefore, it seems that considering the laboratory parameters can be useful in patients with trauma.