TRISS analysis of trauma care: a Yugoslav perspective

The TRISS method has been claimed to be useful in the evaluation of trauma care. The aim of this study was to compare our data with Major Trauma Outcome Study (MTOS) results in North America, and to note differences and strive to improve care in our system. Data were collected from 163 consecutively admitted trauma patients to the Intensive Care Unit, Accident and Emergency Centre, Belgrade, Yugoslavia. Systolic blood pressure, respiration rate and Glasgow Coma Score were obtained on admission and the Abbreviated Injury Score was presented by anatomical area. Data were analysed on an Amstrad PCW computer, using a special non-commercial program. The calculated expected survival out of 163 cases was 131.7 and observed 111 patients. Distribution of severity of injury of the study population had a greater severity of injury than did the baseline. Thus, although the observed survival was less than expected, this is not conclusive evidence of worse care. This applies especially to the group of patients over 54 years of age who suffered blunt trauma, whose higher mortality (23 observed and 15.6 expected out of 50 patients) can be attributed to the ISS score being almost double that of the MTOS population of comparable age. Penetrating trauma patients, in spite of severe injuries, had better survival than predicted. The TRISS method, in spite of its limitations, proved a useful method of evaluating trauma care, and can be run on a small computer without the necessity for special staff.