Prediction of mortality in pediatric trauma patients: New injury severity score outperforms injury severity score in the severely injured

Authors

Thomas Sullivan, New York Medical College, Valhalla, USA
Adil H. Haider, New York Medical College, Valhalla, USAFollow
Stephen M. DiRusso, New York Medical College, Valhalla, USA
Peter Nealon, New York Medical College, Valhalla, USA
Aasma Shaukat, New York Medical College, Valhalla, USA
Michel Slim, New York Medical College, Valhalla, , USA

Document Type

Article

Department

General Surgery

Abstract

Background: The Injury Severity Score (ISS) is a widely accepted method of measuring severity of traumatic injury. A modification has been proposed--the New Injury Severity Score (NISS). This has been shown to predict mortality better in adult trauma patients, but it had no predictive benefit in pediatric patients. The aim of this study was to determine whether the NISS outperforms the ISS in a large pediatric trauma population.
Methods: Admissions in the National Pediatric Trauma Registry between April 1996 and September 1999 were included. The ISS and NISS were calculated for each patient. The study endpoints were mortality at hospital discharge, functional outcome in three domains (expression, locomotion, and feeding), and discharge disposition for the survivors. Predictive ability of each score was assessed by area under the receiver operating characteristic curve.
Results: The NISS and ISS performed equally well at predicting mortality in patients with lower injury severity (ISS < 25), but the NISS was significantly better at predicting mortality in the more severely injured patients. Both scores performed equally well at predicting expression and feeding ability. The NISS was superior to the ISS in predicting locomotion ability at discharge. Thirty-seven percent of patients had an NISS that was higher than their ISS. These patients had a significantly higher mortality and suffered worse functional outcomes.
Conclusion: The NISS performs as well as the ISS in pediatric patients with lower injury severity and outperforms the ISS in those with higher injury severity

Comments

This work was published before the author joined Aga Khan University

Publication (Name of Journal)

The Journal of trauma

Recommended Citation

Sullivan, T., Haider, A. H., DiRusso, S. M., Nealon, P., Shaukat, A., Slim, M. (2003). Prediction of mortality in pediatric trauma patients: New injury severity score outperforms injury severity score in the severely injured. The Journal of trauma, 55(6), 1083-7.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_gen/329