多机构结局评估结果：对创伤和损伤严重度评分（TRISS）指定的意外结局进行结构化同行评审的结果

Results of a multi-institutional outcome assessment: results of a structured peer review of TRISS-designated unexpected outcomes.

作者信息

Karmy-Jones R, Copes W S, Champion H R, Weigelt J, Shackford S, Lawnick M, Rozycki G S, Hollingsworth-Fridlund P, Klein J

机构信息

Department of Surgery, Washington Hospital Center, Washington, DC 20010.

出版信息

J Trauma. 1992 Feb;32(2):196-203.

PMID:1740802

Abstract

The utility of TRISS as a component of trauma center quality assurance (QA) was evaluated. TRISS survival probabilities were estimated for a total of 2,023 consecutive trauma patients admitted to three level-I trauma centers during a 6-month period. A structured peer review was performed of the 50 patients (2.1%) having statistically unexpected outcomes. For 23 (18 survivors, five deaths) TRISS-designated outcomes were sustained in peer review. In 27 cases (one survivor, 26 deaths) TRISS-designated outcomes were not sustained by peer review and TRISS. Limitations were identified in each case. Peer review of unexpected outcomes identified by TRISS provided a consistent and objective QA methodology. An understanding of TRISS as an objective component of the trauma center QA process is essential in blending it with what is, at present, a largely subjective process in many hospitals. Use of TRISS standardizes the peer review process, resulting in a more reliable base for development and improvement of trauma center QA programs.

摘要

评估了创伤严重度特征评分（TRISS）作为创伤中心质量保证（QA）组成部分的效用。对在6个月期间入住三家一级创伤中心的总共2023例连续创伤患者估计了TRISS生存概率。对50例（2.1%）具有统计学意外结果的患者进行了结构化同行评审。在同行评审中，23例（18例存活，5例死亡）TRISS指定的结果得以维持。在27例病例中（1例存活，26例死亡），TRISS指定的结果未得到同行评审和TRISS的支持。在每个病例中都发现了局限性。对TRISS识别出的意外结果进行同行评审提供了一种一致且客观的质量保证方法。将TRISS理解为创伤中心质量保证过程的一个客观组成部分，对于将其与目前许多医院中很大程度上主观的过程相结合至关重要。使用TRISS使同行评审过程标准化，为创伤中心质量保证计划的制定和改进提供了更可靠的基础。