Schluter Philip J, Cameron Cate M, Davey Tamzyn M, Civil Ian, Orchard Jodie, Dansey Rangi, Hamill James, Naylor Helen, James Carolyn, Dorrian Jenny, Christey Grant, Pollard Cliff, McClure Rod J
School of Public Health and Psychosocial Studies, AUT University, Auckland, New Zealand.
N Z Med J. 2009 Sep 11;122(1302):54-64.
To develop local contemporary coefficients for the Trauma Injury Severity Score in New Zealand, TRISS(NZ), and to evaluate their performance at predicting survival against the original TRISS coefficients.
Retrospective cohort study of adults who sustained a serious traumatic injury, and who survived until presentation at Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Coefficients were estimated using ordinary and multilevel mixed-effects logistic regression models.
1735 eligible patients were identified, 1672 (96%) injured from a blunt mechanism and 63 (4%) from a penetrating mechanism. For blunt mechanism trauma, 1250 (75%) were male and average age was 38 years (range: 15-94 years). TRISS information was available for 1565 patients of whom 204 (13%) died. Area under the Receiver Operating Characteristic (ROC) curves was 0.901 (95%CI: 0.879-0.923) for the TRISS(NZ) model and 0.890 (95% CI: 0.866-0.913) for TRISS (P<0.001). Insufficient data were available to determine coefficients for penetrating mechanism TRISS(NZ) models.
Both TRISS models accurately predicted survival for blunt mechanism trauma. However, TRISS(NZ) coefficients were statistically superior to TRISS coefficients. A strong case exists for replacing TRISS coefficients in the New Zealand benchmarking software with these updated TRISS(NZ) estimates.
制定新西兰创伤严重度评分（TRISS）的当地当代系数，即TRISS（NZ），并评估其在预测生存率方面相对于原始TRISS系数的表现。
对2002年至2006年间遭受严重创伤且存活至在奥克兰市、米德尔莫尔、怀卡托或北岸医院就诊的成年人进行回顾性队列研究。使用普通和多级混合效应逻辑回归模型估计系数。
确定了1735例符合条件的患者，其中1672例（96%）因钝性机制受伤，63例（4%）因穿透性机制受伤。对于钝性机制创伤，1250例（75%）为男性，平均年龄为38岁（范围：15 - 94岁）。1565例患者有TRISS信息，其中204例（13%）死亡。TRISS（NZ）模型的受试者操作特征（ROC）曲线下面积为0.901（95%CI：0.879 - 0.923），TRISS为0.890（95%CI：0.866 - 0.913）（P<0.001）。没有足够的数据来确定穿透性机制TRISS（NZ）模型的系数。
两种TRISS模型都能准确预测钝性机制创伤的生存率。然而，TRISS（NZ）系数在统计学上优于TRISS系数。有充分理由用这些更新后的TRISS（NZ）估计值取代新西兰基准软件中的TRISS系数。
