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Pediatric coefficients for TRISS analysis

M R Eichelberger1, H R Champion, W J Sacco

  • 1Emergency Trauma Services, Children's National Medical Center, Washington, DC 20010.

The Journal of Trauma
|March 1, 1993
PubMed
Summary
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The adult trauma norm for Trauma and Injury Severity Score (TRISS) analysis reliably predicts survival in pediatric patients. This study found no significant differences between adult and pediatric norms, recommending continued use of the adult norm for consistency in trauma care evaluation.

Area of Science:

  • Trauma Surgery
  • Pediatric Critical Care
  • Biostatistics

Background:

  • The Trauma and Injury Severity Score (TRISS) is a widely used tool for predicting trauma patient survival.
  • Established TRISS norms are primarily based on adult data, necessitating evaluation for pediatric populations.
  • Accurate survival prediction is crucial for assessing trauma care quality in children.

Purpose of the Study:

  • To evaluate the efficacy of the adult TRISS blunt trauma norm in predicting survival for pediatric trauma patients.
  • To compare the predictive accuracy and reliability of adult versus pediatric TRISS norms.
  • To determine if the adult norm is a suitable alternative for pediatric trauma analysis.

Main Methods:

  • Regression coefficients were calculated for TRISS analysis using data from 4271 pediatric patients (aged 1-14 years) from the Major Trauma Outcome Study.

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  • Predicted survival probabilities using both adult and pediatric TRISS norms were compared against actual survival outcomes.
  • Statistical analysis assessed differences in predicted versus actual survivors, and evaluated norm discrimination and reliability.

    • Main Results:

    • No statistically significant differences were observed between predicted and actual numbers of survivors when using either the adult or pediatric TRISS norm.
    • Discrimination and reliability between the adult blunt trauma norm and the pediatric norm were found to be minimal.
    • The adult blunt TRISS norm demonstrated high discriminating power and reliability for predicting pediatric patient survival.

    Conclusions:

    • The adult TRISS blunt norm is a highly discriminating and reliable tool for predicting survival probabilities in pediatric trauma patients.
    • Both adult and pediatric TRISS norms performed equally well in predicting survival outcomes for children.
    • The authors recommend the continued use of the adult blunt trauma norm for estimating pediatric survival probability to ensure a consistent system for evaluating trauma care.