Vetri Rishwanth, Piramanayagam Dhanabalan, Ravi Preethy
Department of General Surgery, Stanley Medical College, Chennai, Tamil Nadu, India.
Department of General Surgery, Government Thoothukudi Medical College and Hospital, Thoothukudi, Tamil Nadu, India.
Int J Crit Illn Inj Sci. 2024 Jan-Mar;14(1):21-25. doi: 10.4103/ijciis.ijciis_38_23. Epub 2024 Mar 27.
Globally, trauma cases have significant morbidity and mortality. Hence, various scoring systems have been designed to improve the prognosis in trauma cases. Trauma and Injury Severity Score (TRISS) is one of the widely used models to predict mortality; however, it has certain limitation. We have aimed to evaluate the survival prediction of new model TRISS-oxygen saturation (SpO) and to compare with original TRISS score in trauma study participants.
This was a prospective cohort study conducted on 380 trauma study participants admitted to the surgery department from January 20, 2021, to November 28, 2021. The proposed model includes TRISS-SpO which replaces pulse SpO instead of revised trauma score in the original TRISS score. Probability of survival (Ps) was calculated for both models using coefficients derived from Walker-Duncan regression analysis analyzed from the Major Trauma Outcome Study. Receiver operating characteristic curve analysis was used to predict model performance and the accuracy was calculated.
The mortality rate in the present study was 30 (7.9%). The predictive accuracy of original TRISS score which calculated Ps based on respiratory rate was 97.11%, and for the proposed model of TRISS score which calculated Ps based on SpO was found 97.11%, and thus there is no significant difference in the performance.
The new proposed model TRISS-SpO showed a good accuracy which is similar to original TRISS score. However, the new tool TRISS-SpO might be easier to use for robust performance in the clinical setting.
在全球范围内，创伤病例具有较高的发病率和死亡率。因此，人们设计了各种评分系统来改善创伤病例的预后。创伤和损伤严重程度评分（TRISS）是广泛用于预测死亡率的模型之一；然而，它有一定的局限性。我们旨在评估新模型TRISS-血氧饱和度（SpO）的生存预测能力，并在创伤研究参与者中与原始TRISS评分进行比较。
这是一项前瞻性队列研究，对2021年1月20日至2021年11月28日入住外科的380名创伤研究参与者进行。所提出的模型包括TRISS-SpO，它在原始TRISS评分中取代了脉搏SpO而不是修正创伤评分。使用从重大创伤结局研究分析得出的Walker-Duncan回归分析系数，为两个模型计算生存概率（Ps）。采用受试者工作特征曲线分析来预测模型性能并计算准确性。
本研究中的死亡率为30例（7.9%）。基于呼吸频率计算Ps的原始TRISS评分的预测准确率为97.11%，基于SpO计算Ps的TRISS评分所提出模型的预测准确率为97.11%，因此性能上没有显著差异。
新提出的模型TRISS-SpO显示出与原始TRISS评分相似的良好准确性。然而，新工具TRISS-SpO在临床环境中可能更易于使用以实现强大的性能。
