Reiter Ana, Mauritz Walter, Jordan Barbara, Lang Thomas, Pölzl Alexandra, Pelinka Linda, Metnitz Philipp G H
Department of Anesthesiology and General Intensive Care, University Hospital of Vienna, Vienna, Austria.
J Trauma. 2004 Aug;57(2):375-80. doi: 10.1097/01.ta.0000104016.78539.94.
To test (a) the prognostic performance of TRISS and SAPS II scoring systems in a large sample of trauma patients admitted to Austrian ICUs, and (b) the hypothesis that the prognostic performance of TRISS could be improved by adding SAPS II.
Prospective multicenter cohort study comprising 5,538 trauma patients out of 35,637 patients admitted to 31 ICUs in Austria over a 4-year period.
Separately, TRISS and SAPS II showed lack of calibration in the cohort of trauma patients. The database was then split into two equal samples, development and validation. Using the development sample, a new scoring system was developed, with vital status at hospital discharge as the dependent variable and TRISS and SAPS II as independent variables. The prognostic performance of the new TRISS-SAPS system was then assessed in the validation cohort: Both, discrimination (as shown by area under the ROC curve), and calibration (using Hosmer-Lemeshow goodness-of-fit statistics) was excellent.
We improved risk adjustment in critically ill trauma patients by combining TRISS and SAPS II. This new scoring system might aid in evaluating and comparing specialized trauma ICUs.
(a) 在大量入住奥地利重症监护病房 (ICU) 的创伤患者样本中，测试创伤严重度特征评分（TRISS）和简化急性生理学评分 II（SAPS II）系统的预后性能；(b) 检验以下假设，即通过加入 SAPS II 可改善 TRISS 的预后性能。
前瞻性多中心队列研究，纳入奥地利 31 个 ICU 在 4 年期间收治的 35637 例患者中的 5538 例创伤患者。
单独来看，TRISS 和 SAPS II 在创伤患者队列中均显示出校准不足。然后将数据库分为两个相等的样本，即开发样本和验证样本。使用开发样本，以出院时的生命状态作为因变量，TRISS 和 SAPS II 作为自变量，开发了一种新的评分系统。然后在验证队列中评估新的 TRISS-SAPS 系统的预后性能：判别能力（通过 ROC 曲线下面积显示）和校准（使用 Hosmer-Lemeshow 拟合优度统计量）均表现出色。
我们通过结合 TRISS 和 SAPS II 改善了重症创伤患者的风险调整。这种新的评分系统可能有助于评估和比较专门的创伤 ICU。
