The use of Trauma Score-Injury Severity Score (TRISS) at Siriraj Hospital: how accurate is it?

OBJECTIVE Trauma Score-Injury Severity Score (TRISS) is one of the most universally deployed scores. It is based on both the physiologic Revised Trauma Score (RTS) and anatomic Injury Severity Score (ISS). The purpose of the present study was to validate the accuracy of the TRISS methodology to predict survival of admitted trauma patients at Siriraj Hospital when compared with the actual mortality (discharged or dead) during 1-year period. MATERIAL AND METHOD One thousand four hundred eighty seven trauma patients were admitted to the Division of Trauma Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital between October 1, 2004 and September 30, 2005. The probability of survival (Ps) was calculated for each patient according to the TRISS method. It was used to assess injury severity and to compare with the actual outcome in injured patients. The data was analyzed by SPSS version 12. RESULTS The majority of the patients were men (77.1%), mean age 38.7 +/- 19.8 years; 75.0% were blunt injuries. The mean Revised Trauma Score (RTS) was 7.6 +/- 0.8 and the mean Injury Severity Score (ISS) was 10.2 +/- 8.3. The cut-off value for Ps > 95.0% was the most accurate level of TRISS of which the sensitivity and specificity of the TRISS methodology were 90.9% and 97.2% respectively CONCLUSION Accuracy of TRISS methodology for prediction of survival of the patients in Siriraj Hospital was confirmed, and improved by adjusting the cut-off value.