Department of Surgery, Emory University, Atlanta, GA, USA.
Georgia Quality Improvement Program, Madison, GA, USA.
Am Surg. 2024 Jul;90(7):1928-1930. doi: 10.1177/00031348241241630. Epub 2024 Mar 25.
Injury Severity Score (ISS) has limited utility as a prospective predictor of trauma outcomes as it is currently scored by abstractors post-discharge. This study aimed to determine accuracy of ISS estimation at time of admission. Attending trauma surgeons assessed the Abbreviated Injury Scale of each body region for patients admitted during their call, from which estimated ISS (eISS) was calculated. The eISS was considered concordant to abstracted ISS (aISS) if both were in the same category: mild (<9), moderate (9-15), severe (16-25), or critical (>25). Ten surgeons completed 132 surveys. Overall ISS concordance was 52.2%; 87.5%, 30.8%, 34.8%, and 61.7% for patients with mild, moderate, severe, and critical aISS, respectively; unweighted k = .36, weighted k = .69. This preliminarily supports attending trauma surgeons' ability to predict severity of injury in real time, which has important clinical and research implications.
损伤严重度评分 (ISS) 作为创伤结局的前瞻性预测指标的效用有限,因为它目前是在出院后由摘要员进行评分的。本研究旨在确定入院时 ISS 估计的准确性。主治创伤外科医生对在其值班期间入院的每位患者的简明损伤量表进行评估,由此计算出预计 ISS (eISS)。如果 eISS 和摘要 ISS (aISS) 都在同一类别中:轻度 (<9)、中度 (9-15)、重度 (16-25) 或极重度 (>25),则认为两者一致。10 名外科医生完成了 132 份调查。总体 ISS 一致性为 52.2%;aISS 为轻度、中度、重度和极重度的患者的 ISS 一致性分别为 87.5%、30.8%、34.8%和 61.7%;未加权 k =.36,加权 k =.69。这初步支持主治创伤外科医生实时预测损伤严重程度的能力,这具有重要的临床和研究意义。