A prospective cohort study evaluating the TRISS and TRISS-SpO2 scoring systems for assessing mortality risk in trauma study participants in India.

Abstract

Background: Globally, trauma cases have significant morbidity and mortality. Hence, various scoring systems have been designed to improve the prognosis in trauma cases. Trauma and Injury Severity Score (TRISS) is one of the widely used models to predict mortality; however, it has certain limitation. We have aimed to evaluate the survival prediction of new model TRISS-oxygen saturation (SpO₂) and to compare with original TRISS score in trauma study participants.

Methods: This was a prospective cohort study conducted on 380 trauma study participants admitted to the surgery department from January 20, 2021, to November 28, 2021. The proposed model includes TRISS-SpO₂ which replaces pulse SpO₂ instead of revised trauma score in the original TRISS score. Probability of survival (Ps) was calculated for both models using coefficients derived from Walker-Duncan regression analysis analyzed from the Major Trauma Outcome Study. Receiver operating characteristic curve analysis was used to predict model performance and the accuracy was calculated.

Results: The mortality rate in the present study was 30 (7.9%). The predictive accuracy of original TRISS score which calculated Ps based on respiratory rate was 97.11%, and for the proposed model of TRISS score which calculated Ps based on SpO₂ was found 97.11%, and thus there is no significant difference in the performance.

Conclusions: The new proposed model TRISS-SpO₂ showed a good accuracy which is similar to original TRISS score. However, the new tool TRISS-SpO₂ might be easier to use for robust performance in the clinical setting.