PubMed · 2819313
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N Brooks. Defining outcome.. https://doi.org/10.3109/02699058909004556
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We compared the Abbreviated Injury Scale (AIS-85) and the Hospital Trauma Index (HTI) in seriously injured patients. The effect of these scales on the application of Injury Severity Scores (ISS) was investigated. Furthermore, the predictive value on mortality of the AIS/ISS and the HTI/ISS was determined. Subjects were 932 seriously injured patients (HTI/ISS score greater than or equal to 18) admitted to University Hospital Groningen between 1985 and 1990. A quantitative and a qualitative comparison were performed. Logistic regression was used to estimate the predictive value of the AIS/ISS and the HTI/ISS on mortality. The AIS/ISS and HTI/ISS differed quantitatively and qualitatively. The average HTI/ISS score was ten points higher than the average AIS/ISS. By combining specific regions of the scales the predictive value could be improved. The ISS scores were incomparable. Consequently in future studies the method used to calculate the ISS score should be mentioned.
The effect of trauma may be graded by the extent of anatomical injury caused or functional derangement created. The anatomical scoring is useful in determining the trauma load in a hospital and for comparisons between hospitals. It correlates well with the need for resources. Functional scoring may be used to follow the effect of treatment of the individual patient. A combined evaluation of both anatomical injuries, physiological derangements and patient's age is necessary for individual prognostics and is used in evaluation of trauma care. The most widely used system of anatomical scoring is Injury Severity Score based on the Abbreviated Injury Scale. Trauma Score is a widely disseminated functional scoring system. These two may be combined into the TRISS method for assessing probability of survival. Under conditions of war, patients are divided into groups which either have to be operated, which can wait or which have to wait. War wounds are graded according to the extent of soft tissue damage, involvement of deeper structures and whether the wound contains foreign bodies.