Comparative study of four maxillofacial trauma scoring systems and expert score.

PURPOSE

To select a scoring system suitable for the scoring of maxillofacial trauma by comparing 4 commonly used scoring systems according to expert scoring.

PATIENTS AND METHODS

Twenty-eight subjects who had experienced maxillofacial trauma constituted the study cohort. Four commonly used systems were selected: New Injury Severity Score (NISS), Facial Injury Severity Scale (FISS), Maxillofacial Injury Severity Score (MFISS), and Maxillofacial Injury Severity Score (MISS). Each patient was graded using these 4 systems. From the experience of our trauma center, an expert scoring table was created. After the purpose and scheme of the study had been explained, 35 experts in maxillofacial surgery were invited to grade the injury of the 28 patients using the expert scoring table according to their clinical experience. The results of the 4 scoring systems and expert score were compared.

RESULTS

The results of the 4 scoring systems and expert score demonstrated a normal distribution. All results demonstrated significant differences (P < .01). The Pearson correlation coefficient between the MFISS and expert score was the greatest (0.801). The correlation coefficient between the NISS, FISS, and MISS and the expert score was 0.714, 0.699, and 0.729, respectively. Agreement between the standardized scores and the expert score was evaluated using Bland-Altman plots; the agreement between the standardized MFISS and expert score was the best.

CONCLUSIONS

Compared with the other 3 scoring systems, the correlation and agreement between the MFISS and expert score was greater. This finding suggests that the MFISS is more suitable for scoring maxillofacial injuries.