Cooke R S, McNicholl B P, Byrnes D P
Department of Neurosurgery, Royal Victoria Hospital, Belfast, UK.
Injury. 1995 Jul;26(6):399-400. doi: 10.1016/0020-1383(95)00064-g.
As part of a study of the early management of severe head injury, the use of the Glasgow Coma Score (GCS), Injury Severity Score (ISS) and TRISS was investigated. These injury scores were compared in correlating with outcome at one year as assessed by the Glasgow Outcome Score (GOS) and mortality. One hundred and thirty-one patients had a severe head injury, as defined by an ISS of 16 or higher, in whom the Abbreviated Injury Score (AIS) for craniocerebral injury was 3 or higher. Seventy-eight of these also fulfilled the accepted GCS definition of severe head injury (GCS less than 8 with no eye-opening). Thirty-eight had evacuation of an acute intracranial haematoma; 26 of these patients would not have been classified as severe head injury by GCS. The overall mortality rate was 38 per cent, and 24 per cent for those transferred to the neurosurgical unit. TRISS was slightly better than GCS for predicting outcome based on both GOS and mortality, however this difference was not significant. TRISS identified patients who died that are not considered as severe head injury by GCS. Use of TRISS allows the effects of systemic factors and other injuries to be taken into account when assessing severity of head injury.
作为重度颅脑损伤早期处理研究的一部分，对格拉斯哥昏迷评分（GCS）、损伤严重度评分（ISS）和创伤严重度特征评分（TRISS）的应用进行了调查。将这些损伤评分与通过格拉斯哥预后评分（GOS）评估的一年预后及死亡率进行相关性比较。131例患者为重度颅脑损伤，定义为ISS为16或更高，其中颅脑损伤的简明损伤评分（AIS）为3或更高。其中78例也符合公认的重度颅脑损伤GCS定义（GCS小于8且无睁眼）。38例进行了急性颅内血肿清除术；其中26例患者按GCS分类不属于重度颅脑损伤。总体死亡率为38%，转入神经外科病房的患者死亡率为24%。基于GOS和死亡率，TRISS在预测预后方面略优于GCS，然而这种差异并不显著。TRISS识别出了那些按GCS不被视为重度颅脑损伤但死亡的患者。使用TRISS在评估颅脑损伤严重程度时能够考虑全身因素和其他损伤的影响。
