Primary verification: is the TRISS appropriate for Thailand?

The Trauma and Injury Severity Score (TRISS) is a well-accepted model used to evaluate the quality of trauma care in the US. This research aims to study whether TRISS can be applied to evaluate trauma care and classify outcomes of road traffic injury patients in Thailand. A retrospective study was used to review the Thailand's Injury Surveillance System database from the 1st January to the 31st of December 1996. The study subjects were severe road traffic injury patients with blunt injuries. The TRISS model was applied to compute the survival probability for each patient. The chi-square goodness-of-fit was used to compare the survival probability distribution between the American Major Trauma Outcome of Study (MTOS) and the road traffic injuries in Thailand. The accuracy, sensitivity and specificity of the survival prediction by TRISS were evaluated. The distribution of survival probability between American trauma patients and Thai road traffic injury patients was significantly different (p-value < 0.00001). The TRISS model had high accuracy and sensitivity, but low specificity, in predicting the survival of Thai road traffic injuries. The MTOS and Thai road traffic injuries had different distributions for various factors such as the Revised Trauma Score (RTS), Injury Severity Score (ISS), and ages which effect injury survival. Due to these factors the distribution of survival probability between MTOS and Thai road traffic injuries was also significantly different. By applying TRISS, the survival prediction of Thai road traffic injuries resulted in a high number of false positives.

in children. Its results were drawn with limited sample size obtained after a short phase of data collection. A further study should be conducted to get more precise and valid results that may be useful for preventing UTI among children.

This hospital-based case-control study was conducted from September 1998 to January 1999 in Metro Manila, Philippines. General objective of the study is to determine the association between selected hygiene behavior and urinary tract infection (UTI) among children aged 6-12 years. Specifically, the study is designed to examine the relationship between UTI and urination, defecation, washing and bathing habits. Twenty-three cases of children with UTI and an equal number of controls were recruited in four tertiary hospitals. The study association was determined by using odds ratio, the chi-square test and the Fisher exact test, where appropriate, in simple analysis. Furthermore, exact logistic regression analysis was applied to overcome the problem of small sample size. The data suggested that bathing habit less than daily, holding of urination during daytime, and washing habit after defecation might have risk effects on UTI. There was not enough evidence of significant association between UTI and other study exposures. Among extraneous variables, age group or school enrollment of children had a borderline significant association with UTI after adjusted simultaneously for selected variables. This study served as a pilot of the Preventive Nephrology Project (Department of Health, Philippines) in determining selected risk factors of

Prenatal tetanus immunization and other practices associated with neonatal tetanus.

The relationship between neonatal tetanus (NT) on one hand, and maternal tetanus immunization and other prenatal and natal practices on the other hand, was examined in a case-control study done at San Lazaro Hospital (SLH) in Manila from late 1990 to mid 1991. Included as cases were 54 patients diagnosed as NT on the basis of WHO criteria, and 50 controls who were patients 0-4 months of age, hospitalized at SLH during the study period and with no past history of tetanus. The result showed that the following were statistically associated with the risk of NT: home delivery (OR = 30.5); delivered by a traditional birth attendant (OR = 5.2); use of instrument other than scissors to cut the cord (OR = 19.3); traditional birth attendant who dressed the cord (OR = 12.7); and having less than two doses of tetanus toxoid (OR = 15.3). The need to intensify prenatal tetanus immunization, health education of the mothers as well as the training of birth attendants is evident from this study if NT has to be prevented.