Comparing NEWS2, TRISS, and RTS in predicting mortality rate in trauma patients based on prehospital data set: a...

Area of Science:

• Trauma care research
• Medical scoring systems
• Predictive analytics in healthcare

Background:

• National Early Warning Score 2 (NEWS2) is increasingly used for early detection of patient deterioration.
• The comparative predictive accuracy of NEWS2, Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) for trauma mortality has not been established.
• This study addresses the need to compare these key scoring systems using prehospital data.

Purpose of the Study:

• To compare the prognostic accuracy of NEWS2, TRISS, and RTS in predicting in-hospital mortality among trauma patients.
• To evaluate the effectiveness of these scoring systems based on prehospital data.
• To identify the most accurate scoring system for early mortality prediction in trauma.

Main Methods:

• A cross-sectional retrospective diagnostic study was conducted on 4191 eligible trauma patients from a major trauma center in southern Iran (2022-2023).
• Prehospital data, including demographic information, vital signs, and Glasgow Coma Scale (GCS), were collected.
• Scoring systems (NEWS2, RTS, TRISS, ISS) were calculated and compared between deceased and survived patient groups.

Main Results:

• TRISS exhibited the highest accuracy with an Area Under the ROC Curve (AUC) of 0.934, followed by NEWS2 (0.879).
• TRISS and RTS demonstrated high sensitivity (77.52%) and specificity (93.99%), respectively.
• TRISS and NEWS2 were found to be significantly superior to RTS, GCS, and ISS in predicting mortality (p < 0.0001).

Conclusions:

• All evaluated scoring systems (NEWS2, TRISS, RTS) can predict mortality in trauma patients using prehospital data.
• TRISS is the most accurate predictor, with NEWS2 being the second most accurate.
• NEWS2 offers a balance of accuracy and efficiency, making it a practical choice for rapid prehospital mortality prediction.