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TIME FOR CHANGE IN VARIABLES USED FOR CALCULATING PROBABILITY OF SURVIVAL FOR TRAUMA PATIENTS?

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Aim of study (background): Probability of survival (Ps) is calculated presently by using the TRISS methodology. This utilises physiological scoring parameters, injury scoring system and age. The physiological parameters need to be recorded for determining the RTS, but are frequently missed. The aim of my study was to assess if any other variables contribute significantly to the Probability of survival, and if they do is it time to change the variables used to calculate the Probability of survival?

Material and methods: A retrospective study was carried out from January’01 to August’03. The relationship between Injury Severity Score (ISS), Revised Trauma Score (RTS), age and Glasgow Coma Score (GCS) with Probability of survival was assessed using the correlation and regression analysis and then the affect of gender on probability of survival was assessed.

Results: ISS had a mean of 21.69 (range, 2–50). The results showed a strong negative correlation between ISS and Ps with an r value of −0.692 (p< 0.005). GCS correlated strongly with Ps, with an r value of 0.457 (p< 0.005). In the regression analysis; ISS, RTS, age and GCS showed a strong correlation with Ps. RTS made the strongest unique contribution to Ps, followed by age, ISS and then GCS. There also was a significant difference in the mean scores of Ps for males and females (p< 0.005).

Conclusion: The results indicated significantly strong correlations between GCS and Ps. This is helpful for the patients in whom RTS scores cannot be calculated, as GCS can be used in place of RTS. Results also showed that gender affects Ps and hence could be used in calculations. There may be a need for a new system to calculate Ps using GCS and gender.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.