Correlation Analysis of Trauma Scoring System in Predictive Validity in Motor Vehicle Accident

ABSTRACT

PURPOSE: The Trauma Scoring System is used for triage and treatment decision-making of injured patients. An ideal scoring system should have predictive validity, correlate with outcome, be easily applicable, and be reliably applied among observations. The purpose of this study was to analysis the trauma scoring system to predict motor vehicle accident (MVA) survival and mortality. METHODS: The registry data of MVA trauma patients admitted to W hospital between October 2008 and December 2009 were retrospectively reviewed. The dependent variable of interest was patient survival (coded as live or die). The independent variables used in the study included the full term for ISS (ISS) derived using Abbreviated Injury Score (AIS) and body system maximum AIS scores, full term (ICISS) score, full term (RTS) and full term (TRISS). Survival predictability in each scoring system (ISS, RTS TRISS, ICISS and ICISS full model) was compared. RESULTS: Trauma severity scores of the 1,843 patients [1,163 males (63.1%), 680 females (36.9%); mean age 41.7+/-20.9 years] were RTS 7.36+/-3.23 (median 7.84), ISS 6.42+/-8.42 (median 4), TRISS 0.952+/-0.153 (median 0.994), ICISS 0.970+/-0.055 (median 0.990), and ICISS full model 0.982+/-0.104 (median 0.998). To analyze the predictive validity of the receiver operation characteristic (ROC) curve analysis, ISS 0.956, ICISS 0.522, ICISS full model 0.398, RTS 0.095, and TRISS 0.368 appeared to predict the validity of the widest area of the ROC curve area, with ISS being most reliable. CONCLUSION: ISS is the best predictor of survival than the other derived other scoring systems for MVA patients.