Wang M D, Fan W H, Qiu W S, Zhang Z L, Mo Y N, Qiu F
Department of Emergency Medicine, Affiliated Hospital of Hangzhou Normal University, 126 Wenzhou Road, Gongshu District, Hangzhou, 310015, Zhejiang, People's Republic of China.
Department of Neurosurgery, Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, Zhejiang, People's Republic of China.
Eur J Trauma Emerg Surg. 2014 Jun;40(3):287-94. doi: 10.1007/s00068-013-0331-1. Epub 2013 Oct 5.
We present here the exponential function which transforms the Abbreviated Injury Scale (AIS). It is called the Exponential Injury Severity Score (EISS), and significantly outperforms the venerable but dated New Injury Severity Score (NISS) and Injury Severity Score (ISS) as a predictor of mortality.
The EISS is defined as a change of AIS values by raising each AIS severity score (1-6) by 3 taking a power of AIS minus 2 and then summing the three most severe injuries (i.e., highest AIS), regardless of body regions. EISS values were calculated for every patient in two large independent data sets: 3,911 and 4,129 patients treated during a 6-year period at the Class A tertiary hospitals in China. The power of the EISS to predict mortality was then compared with previously calculated NISS values for the same patients in each of the two data sets.
We found that the EISS is more predictive of survival [Zhejiang: area under the receiver operating characteristic curve (AUC): NISS = 0.932, EISS = 0.949, P = 0.0115; Liaoning: AUC: NISS = 0.924, EISS = 0.942, P = 0.0139]. Moreover, the EISS provides a better fit throughout its entire range of prediction (Hosmer-Lemeshow statistic for Zhejiang: NISS = 21.86, P = 0.0027, EISS = 13.52, P = 0.0604; Liaoning: NISS = 23.27, P = 0.0015, EISS = 15.55, P = 0.0164).
The EISS may be used as the standard summary measure of human trauma.
我们在此展示一种用于转换简明损伤定级标准（AIS）的指数函数。它被称为指数损伤严重度评分（EISS），作为死亡率预测指标，其显著优于古老但过时的新损伤严重度评分（NISS）和损伤严重度评分（ISS）。
EISS的定义为，将每个AIS严重度评分（1 - 6）提升至3次幂（以AIS减2为指数）来改变AIS值，然后对最严重的三处损伤（即最高的AIS值）求和，而不考虑身体部位。在两个大型独立数据集里，对每位患者计算EISS值：中国A类三级医院在6年期间治疗的3911例和4129例患者。然后将EISS预测死亡率的能力与在这两个数据集中相同患者先前计算的NISS值进行比较。
我们发现EISS对生存的预测性更强[浙江：受试者工作特征曲线下面积（AUC）：NISS = 0.932，EISS = 0.949，P = 0.0115；辽宁：AUC：NISS = 0.924，EISS = 0.942，P = 0.0139]。此外，EISS在其整个预测范围内拟合度更好（浙江的Hosmer - Lemeshow统计量：NISS = 21.86，P = 0.0027，EISS = 13.52，P = 0.0604；辽宁：NISS = 23.27，P = 0.0015，EISS = 15.55，P = 0.0164）。
EISS可作为人类创伤的标准汇总指标。
