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New Injury Severity Score Is a Better Predictor of Mortality for Blunt Trauma Patients Than the Injury Severity Score

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Abstract

Background

Trauma-related mortality depends on injury severity. Several trauma scores are used to evaluate injury severity. We compared the Injury Severity Score (ISS) and the New Injury Severity Score (NISS) in terms of predicting mortality among hospitalized blunt trauma patients.

Methods

The data of Al-Ain Hospital Trauma Registry were prospectively collected over 3 years. Data of blunt trauma patients were then analyzed retrospectively. Univariate analysis was used to compare patients who died with those who survived. Sex, age, mechanism of injury, heart rate, systolic blood pressure (SBP), and Glasgow Coma Score (GSC) on arrival at the hospital, ISS, and NISS were studied. Significant factors were then entered into a direct likelihood ratio logistic regression model.

Results

Of 2,573 patients in the registry, 2,115 (82.2 %) suffered blunt trauma at a mean (SD) age of 32 (15.3) years. Among them, 1,838 (87 %) were male. Main mechanisms of injury were road traffic collision (vehicle occupants) (32.8 %) and falling from a height (22.4 %). Fifty patients (2.4 %) died. Univariate analysis showed that GCS and SBP at hospital arrival, ISS, NISS, and mechanism of injury significantly affected mortality. Logistic regression model showed that mortality was significantly increased by low GCS (p < 0.0001), high NISS (p < 0.0001), and low SBP (p = 0.006) at hospital arrival.

Conclusions

Mortality of blunt trauma in the UAE is significantly affected by high NISS, low GCS, and hypotension. NISS is better than ISS for predicting mortality of blunt trauma patients and may replace it.

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Acknowledgments

This study was supported by an Individual University Grant (# 01-07-8-11/03), Faculty of Medicine Research Grants (NP/03/11, 2003 and NP/04/28, 2004), and an Interdisciplinary Grant (#02-07-8-1/4).

Conflicts of interest

All authors declare that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, College of Medicine and Health Sciences, UAE University, PO Box 17666, Al-Ain, United Arab Emirates

    Hani O. Eid & Fikri M. Abu-Zidan

  2. Department of Surgery, Al-Ain Hospital, Al-Ain, United Arab Emirates

    Fikri M. Abu-Zidan

Authors
  1. Hani O. Eid
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  2. Fikri M. Abu-Zidan
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Correspondence to Fikri M. Abu-Zidan.

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Eid, H.O., Abu-Zidan, F.M. New Injury Severity Score Is a Better Predictor of Mortality for Blunt Trauma Patients Than the Injury Severity Score. World J Surg 39, 165–171 (2015). https://doi.org/10.1007/s00268-014-2745-2

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