Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
World Journal of Surgery
Published in: World Journal of Surgery 1/2015

01-01-2015 | Original Scientific Report

New Injury Severity Score Is a Better Predictor of Mortality for Blunt Trauma Patients Than the Injury Severity Score

Authors: Hani O. Eid, Fikri M. Abu-Zidan

Published in: World Journal of Surgery | Issue 1/2015

Login to get access

Abstract

Background

Trauma-related mortality depends on injury severity. Several trauma scores are used to evaluate injury severity. We compared the Injury Severity Score (ISS) and the New Injury Severity Score (NISS) in terms of predicting mortality among hospitalized blunt trauma patients.

Methods

The data of Al-Ain Hospital Trauma Registry were prospectively collected over 3 years. Data of blunt trauma patients were then analyzed retrospectively. Univariate analysis was used to compare patients who died with those who survived. Sex, age, mechanism of injury, heart rate, systolic blood pressure (SBP), and Glasgow Coma Score (GSC) on arrival at the hospital, ISS, and NISS were studied. Significant factors were then entered into a direct likelihood ratio logistic regression model.

Results

Of 2,573 patients in the registry, 2,115 (82.2 %) suffered blunt trauma at a mean (SD) age of 32 (15.3) years. Among them, 1,838 (87 %) were male. Main mechanisms of injury were road traffic collision (vehicle occupants) (32.8 %) and falling from a height (22.4 %). Fifty patients (2.4 %) died. Univariate analysis showed that GCS and SBP at hospital arrival, ISS, NISS, and mechanism of injury significantly affected mortality. Logistic regression model showed that mortality was significantly increased by low GCS (p < 0.0001), high NISS (p < 0.0001), and low SBP (p = 0.006) at hospital arrival.

Conclusions

Mortality of blunt trauma in the UAE is significantly affected by high NISS, low GCS, and hypotension. NISS is better than ISS for predicting mortality of blunt trauma patients and may replace it.
Literature
1.
Morris JA Jr, MacKenzie EJ, Damiano AM et al (1990) Mortality in trauma patients: the interaction between host factors and severity. J Trauma 30:1476–1482PubMedCrossRef
2.
3.
Fikri M, Noor AM, Shaheen H (2003) Preventive medicine department 2002 annual report. Ministry of Health, Abu-Dhabi
4.
5.
6.
Jones JM, Skaga NO, Søvik S et al (2014) Norwegian survival prediction model in trauma: modelling effects of anatomic injury, acute physiology, age, and co-morbidity. Acta Anaesthesiol Scand 58:303–315PubMedCrossRef
7.
Moini M, Rezaishiraz H, Zafarghandi MR (2000) Characteristics and outcome of injured patients treated in urban trauma centers in Iran. J Trauma 48:503–507PubMedCrossRef
8.
Lavoie A, Moore L, LeSage N et al (2004) The New Injury Severity Score: a more accurate predictor of in-hospital mortality than the Injury Severity Score. J Trauma 56:1312–1320PubMedCrossRef
9.
Chawda MN, Hildebrand F, Pape HC et al (2004) Predicting outcome after multiple trauma: which scoring system? Injury 35:347–358PubMedCrossRef
10.
Osler T, Baker SP, Long W (1997) A modification of the Injury Severity Score that both improves accuracy and simplifies scoring. J Trauma 43:922–925PubMedCrossRef
11.
Whitaker IY, Gennari TD, Whitaker AL (2003) The difference between ISS and NISS in a series of trauma patients in Brazil. Annu Proc Assoc Adv Automot Med 47:301–309PubMedCentralPubMed
12.
LdeS Nogueira, CdeA Domingues, MdeA Campos et al (2008) Ten years of new injury severity score (NISS): is it a possible change? Rev Lat Am Enfermagem 16:314–319CrossRef
13.
Tay SY, Sloan EP, Zun L et al (2004) Comparison of the New Injury Severity Score and the Injury Severity Score. J Trauma 56:162–164PubMedCrossRef
14.
Zhao XG, Ma YF, Zhang M et al (2008) Comparison of the New Injury Severity Score and the Injury Severity Score in multiple trauma patients. Chin J Traumatol 11:368–371PubMed
15.
Tamim H, Al Hazzouri AZ, Mahfoud Z et al (2008) The Injury Severity Score or the New Injury Severity Score for predicting mortality, intensive care unit admission and length of hospital stay: experience from a university hospital in a developing country. Injury 39:115–120PubMedCrossRef
16.
Hofman K, Primack A, Keusch G et al (2005) Addressing the growing burden of trauma and injury in low-and middle-income countries. Am J Public Health 95:13–17PubMedCentralPubMedCrossRef
17.
Husum H, Strada G (2002) Injury Severity Score versus New Injury Severity Score for penetrating injuries. Prehosp Disaster Med 17:27–32PubMed
18.
19.
20.
21.
Association for the Advancement of Automotive Medicine (1998) The Abbreviated Injury Scale 1990 revision—update 98. Association for the Advancement of Automotive Medicine, Barrington
22.
Munro BH (2001) Selected nonparametric techniques. In: Munro BH (ed) Statistical methods for health care research, 4th edn. Lippincott, New York, pp 97–121
23.
Sperandei S (2014) Understanding logistic regression analysis. Biochem Med (Zagreb) 24:12–18CrossRef
24.
Munro BH (2001) Logistic regression. In: Munro BH (ed) Statistical methods for health care research, 4th edn. Lippincott, New York, pp 283–302
25.
Peduzzi P, Concato J, Feinstein AR et al (1995) Importance of events per independent variable in proportional hazards regression analysis. J Clin Epidemiol 48:1503–1510PubMedCrossRef
26.
Vittinghoff E, McCulloch CE (2007) Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol 165:710–718PubMedCrossRef
27.
Cook A, Weddle J, Baker S et al (2014) A comparison of the Injury Severity Score and the trauma mortality prediction model. J Trauma Acute Care Surg 76:47–52PubMedCrossRef
28.
29.
Yan-Hong L, Rahim Y, Wei L et al (2006) Pattern of traffic injuries in Shanghai: implications for control. Int J Inj Control Saf Promot 13:217–225CrossRef
30.
Li YM, Hu SC, Fu CC (2006) Mortality from motor vehicle crash injuries in eastern Taiwan: a 5-year follow up study. Tzu Chin Med J 18:23–28
31.
Eid HO, Abu-Zidan FM (2007) Biomechanics of road traffic collision injuries: clinician’s perspective. Singapore Med J 48:693–700PubMed
32.
33.
Eid HO, Barss P, Adam SH et al (2009) Factors affecting anatomical region of injury, severity, and mortality for road trauma in a high-income developing country: lessons for prevention. Injury 40:703–707PubMedCrossRef
34.
Belzunegui T, Gradín C, Fortún M et al (2013) Major trauma registry of Navarre (Spain): the accuracy of different survival prediction models. Am J Emerg Med 31:1382–1388PubMedCrossRef
35.
36.
Haleem S, Lutchman L, Mayahi R et al (2008) Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 39:1157–1163PubMedCrossRef
37.
Kockelman KM, Kweon YJ (2002) Driver injury severity: an application of ordered probit models. Accid Anal Prev 34:313–321PubMedCrossRef
38.
Skaga NO, Eken T, Jones JM et al (2008) Different definitions of patient outcome: consequences for performance analysis in trauma. Injury 39:612–622PubMedCrossRef
39.
40.
Bouamra O, Wrotchford A, Hollis S et al (2006) A new approach to outcome prediction in trauma: a comparison with the TRISS model. J Trauma 61:701–710PubMedCrossRef
41.
Ringdal KG, Coats TJ, Lefering R et al (2008) The Utstein template for uniform reporting of data following major trauma: a joint revision by SCANTEM, TARN, DGU-TR and RITG. Scand J Trauma Resusc Emerg Med 16:7PubMedCentralPubMedCrossRef
Metadata
Title
New Injury Severity Score Is a Better Predictor of Mortality for Blunt Trauma Patients Than the Injury Severity Score
Authors
Hani O. Eid
Fikri M. Abu-Zidan
Publication date
01-01-2015
Publisher
Springer US
Published in
World Journal of Surgery / Issue 1/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2745-2

Other articles of this Issue 1/2015

World Journal of Surgery 1/2015 Go to the issue

OriginalPaper

Unmet Burden of Cleft Lip and Palate in Rural Gujarat, India: A Population-Based Study

Original Scientific Report

The Significance of Atrial Fibrillation in Patients Aged ≥55 years Undergoing Abdominal Surgery

Original Scientific Report

Major Post-Operative Complications Predict Long-Term Survival After Esophagectomy in Patients with Adenocarcinoma of the Esophagus

OriginalPaper

Injury, Disability and Access to Care in Rwanda: Results of a Nationwide Cross-Sectional Population Study

Original Scientific Report

Using a Hybrid Electronic Medical Record System for the Surveillance of Adverse Surgical Events and Human Error in A Developing World Surgical Service

Original Scientific Report

Implementing an Enhanced Recovery Program After Pancreaticoduodenectomy in Elderly Patients: Is It Feasible?