Validation of the TRISS model of survival in blunt trauma patients using the Ontario Trauma Registry.

Abstract

Objective. To compare outcomes in blunt trauma by using Trauma and Injury Severity Score (TRISS) models derived from the Major Trauma Outcome Study (MTOS) and the Ontario Trauma Registry as well as to evaluate the role of the Revised Trauma Score (RTS) within the TRISS model. Methods. Consecutive blunt trauma cases from 11 Level I trauma centres over a 4-year period were identified from the OTR. Coefficients of the Revised Trauma Score were modified using the Ontario data and this score's ability to predict mortality was compared to the Revised Trauma Score derived from MTOS. Two Ontario-specific TRISS models were developed with revised coefficients. The first used the standard Revised Trauma Score and the second used the Revised Score with regenerated coefficients. An expanded TRISS model was developed using all the component variables of TRISS and the Revised Trauma Score using forward step-wise logistic regression analysis. The accuracy of mortality predictions for all models were assessed using a Hosmer-Lemeshow Goodness of Fit statistic as well as by estimating sensitivity, specificity (using probability of survival cutpoint of 50%) and the area under the receiver operating characteristic (ROC) curve. (Abstract shortened by UMI.)