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Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Our purpose was to validate the performance of the ISS, NISS, RTS and TRISS scales as predictors of mortality in a population of trauma patients in a Latin American setting.

Materials and methods

Subjects older than 15 years with diagnosis of trauma, lesions in two or more body areas according to the AIS and whose initial attention was at the hospital in the first 24 h were included. The main outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, requirement of mechanical ventilation and length of stay. A logistic regression model for hospital mortality was fitted with each of the scales as an independent variable, and its predictive accuracy was evaluated through discrimination and calibration statistics.

Results

Between January 2007 and July 2015, 4085 subjects were enrolled in the study. 84.2% (n = 3442) were male, the mean age was 36 years (SD = 16), and the most common trauma mechanism was blunt type (80.1%; n = 3273). The medians of ISS, NISS, TRISS and RTS were: 14 (IQR = 10–21), 17 (IQR = 11–27), 4.21 (IQR = 2.95–5.05) and 7.84 (IQR = 6.90–7.84), respectively. Mortality was 9.3%, and the discrimination for ISS, NISS, TRISS and RTS was: AUC 0.85, 0.89, 0.86 and 0.92, respectively. No one scale had appropriate calibration.

Conclusion

Determining the severity of trauma is an essential tool to guide treatment and establish the necessary resources for attention. In a Colombian population from a capital city, trauma scales have adequate performance for the prediction of mortality in patients with trauma.

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Acknowledgements

Supported by “Comité para el Desarrollo de la Investigación (CODI)” Grant 2571 Convocatoria Programática en Ciencias Biomédicas y de la Salud 2012–2013 Universidad de Antioquia.

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Authors and Affiliations

  1. Hospital Pablo Tobón Uribe, Medellín, Colombia

    Carlos Oliver Valderrama-Molina, Nelson Giraldo, Alfredo Constain & Andres Puerta

  2. Universidad de Antioquia, Medellín, Colombia

    Camilo Restrepo & Alba León

  3. Universidad de Antioquia and Hospital Pablo Tobón Uribe, Medellín, Colombia

    Fabián Jaimes

Authors
  1. Carlos Oliver Valderrama-Molina
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  2. Nelson Giraldo
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Correspondence to Carlos Oliver Valderrama-Molina.

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Valderrama-Molina, C.O., Giraldo, N., Constain, A. et al. Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population. Eur J Orthop Surg Traumatol 27, 213–220 (2017). https://doi.org/10.1007/s00590-016-1892-6

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  • DOI: https://doi.org/10.1007/s00590-016-1892-6

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