Beyond Mortality: Does Trauma-related Injury Severity Score Predict Complications or Lengths of Stay Using a Large...

Area of Science:

• Trauma Surgery
• Clinical Outcomes Research
• Health Services Research

Background:

• The Trauma-Related Injury Severity Score (TRISS) is recognized for its correlation with mortality in large trauma datasets.
• Despite TRISS's known utility, its correlation with morbidity and hospital length of stay requires further investigation.
• This study addresses the need to evaluate TRISS's predictive capabilities beyond mortality.

Purpose of the Study:

• To determine if TRISS correlates with morbidity and hospital lengths of stay.
• To compare the predictive performance of TRISS against the Injury Severity Score (ISS) and other clinical variables.
• To test the hypothesis that higher TRISS scores are associated with increased complications and prolonged hospitalizations.

Main Methods:

• Retrospective review of a Level I Trauma Center's registry from January 1999 to June 2015.
• Analysis of 23,205 trauma admissions with available TRISS data.
• Inclusion of variables such as age, gender, ISS, TRISS, complications, GCS, and various lengths of stay (hospital, ICU, step-down).

Main Results:

• TRISS demonstrated superior predictive accuracy for mortality (AUC 0.95) compared to ISS (AUC 0.794), GCS (AUC 0.827), and age (AUC 0.650).
• TRISS also showed strong predictive ability for morbidity events (AUC 0.813), outperforming other variables.
• Higher TRISS scores significantly correlated with longer hospital, step-down unit, and intensive care unit lengths of stay after adjusting for age and gender.

Conclusions:

• TRISS is a superior predictor of both mortality and morbidity in trauma patients compared to ISS.
• TRISS significantly correlates with hospital, step-down unit, and ICU lengths of stay.
• The findings support the continued use and potential expansion of TRISS in trauma outcome assessment.