Aharonson-Daniel Limor, Giveon Adi, Stein Michael, Peleg Kobi
Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel.
J Trauma. 2006 Sep;61(3):711-7. doi: 10.1097/01.ta.0000235294.32326.e6.
Previous studies demonstrated different mortality predictions for identical Injury Severity Scores (ISS) from different Abbreviated Injury Scale (AIS) triplets. This study elaborates in both scope and volume producing results of a larger magnitude, applicable to specific injury subgroups of blunt or penetrating, traumatic brain injury, various age groups, and replicated on NISS.
All patients hospitalized after trauma at 10 hospitals, with ISS/NISS (new ISS) generated by two AIS triplets, excluding patients with isolated minor or moderate injuries to a single body region were studied. Patients were separated into two groups based on the different triplets. Inpatient-mortality rates were calculated for each triplet group. Odds ratios were calculated to estimate the risk of dying in one triplet group as compared with the other. The chi test determined whether the difference in mortality rate between the two groups was significantly different. Differences were further explored for various subgroups.
There were 35,827 patients who had ISS/NISS scores generated by two different AIS triplets. Significant differences in death rates were noted between triplet groups forming identical ISS/NISS. Odds ratio for being in the second group (always containing the higher AIS score) ranged from 2.3 to 7.4.
ISS and NISS that are formed by different AIS triplets have significantly different inpatient-mortality rates. The triplet with the higher AIS score has higher inpatient-mortality rates, overall and in several sub-populations of varying vulnerability. The comparison of populations and the interpretation of ISS/NISS based outcome data should take this important information into account and the components of AIS triplets creating each ISS and NISS should be reported.
先前的研究表明，对于相同的损伤严重程度评分（ISS），不同的简明损伤定级标准（AIS）三联组会得出不同的死亡率预测结果。本研究在范围和体量上都进行了扩展，得出了规模更大的结果，适用于钝性或穿透性创伤性脑损伤的特定损伤亚组、不同年龄组，并在新损伤严重程度评分（NISS）上进行了重复验证。
对10家医院收治的所有创伤后住院患者进行研究，这些患者的ISS/NISS（新ISS）由两个AIS三联组生成，排除仅单个身体部位有轻度或中度损伤的患者。根据不同的三联组将患者分为两组。计算每个三联组组的住院死亡率。计算比值比以估计一个三联组组与另一个三联组组相比的死亡风险。卡方检验确定两组之间的死亡率差异是否具有显著性。对各个亚组进行了进一步探究。
共有35827例患者的ISS/NISS评分由两个不同的AIS三联组生成。在形成相同ISS/NISS的三联组组之间，死亡率存在显著差异。第二组（总是包含较高的AIS评分）的比值比范围为2.3至7.4。
由不同AIS三联组形成的ISS和NISS具有显著不同的住院死亡率。AIS评分较高的三联组总体上以及在几个不同脆弱性的亚人群中具有较高的住院死亡率。在比较人群以及解释基于ISS/NISS的结果数据时，应考虑到这一重要信息，并且应报告创建每个ISS和NISS的AIS三联组组成部分。
