Abstract
Background /Methods: Abbreviated Injury Scale based systems; the ISS, NISS, and AISmax, are used to assess trauma patients. The merits of each in predicting outcome are controversial. A large prospective database was used to assess their predictive capacity using receiver operator characteristic curves.
Results: 13,301 adult patients met the inclusion criteria. All systems were significant outcome predictors for sepsis, multiple organ failure (MOF), length of hospital stay, length of ICU admission and mortality (p 0.0001). NISS was a significantly better predictor than the ISS for mortality (p 0.0001). NISS was equivalent to the AISmax for mortality prediction and superior in patients with orthopaedic injuries. NISS was significantly better for sepsis, MOF, ICU stay and total hospital stay (p 0.0001). Analysis of the ROC curves revealed that the traditional ISS cut-offs for severity of 16, 25 and 50 should be increased to 20, 30 and 55 to provide patients with equivalent outcome.
Conclusions: NISS is superior or equivalent to the ISS and AISmax for prediction of all investigated outcomes in a population of blunt trauma patients. As NISS is easier to calculate, its use is recommended to stratify patients for clinical and research purposes.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
