Assess The Accuracy Of Predictive Scores TRISS, NISS, And APACHE II In Predicting Mortality Among Trauma Patients In Tertiary Care Hospital In South India.

Abstract

AIM: To evaluate and compare the efficacy of TRISS, NISS, and APACHE II scoring systems in predicting mortality among trauma patients. Obejctives: To assess the accuracy of the TRISS, NISS, and APACHE II scores in predicting mortality among trauma patients.To identify different trauma subgroups based on injury mechanism with Status of Patient Survivor.Methodology: Study Design: A retrospective cohort observational study (based on data availability) to evaluate and compare the predictive efficacy of TRISS, NISS, and APACHE II scoring systems among the trauma patient’s mortality. Study Area: Conducted at the Tertiary Care Centre in south India, SRIHER, Chennai. Sample Size:70 Samples doing has a pilot study. Study Population: Patients who admitted with aged 18 years and above within 24 hours of the traumatic event or traumatic injuries, regardless of the mechanism (blunt, penetrating, or others). Result: The study analysed the demographic, trauma scores, and mechanisms of injury data for 70 patients to assess their association with survival outcomes. Age showed no significant association with survival status (p = 0.98), suggesting it does not significantly contribute to trauma score prediction in this cohort. Gender was found to be significantly associated with survival (p = 0.05), with males showing a higher survival rate compared to females. Trauma Scores: The NISS score did not show a significant association with survival (p = 0.91), indicating it is not a reliable predictor in this context. The TRISS score demonstrated borderline statistical significance (p = 0.05), suggesting it has better predictive capabilities compared to the other scoring systems. The APACHE II score showed a trend toward significance (p = 0.06), but it did not meet the threshold for statistical significance. Among the trauma scoring systems, the TRISS score outperformed the NISS and APACHE II scores in predicting mortality, as indicated by the ROC curve analysis. Mechanism of Injury: The mechanism of injury showed a trend toward statistical significance (p = 0.07). Blunt trauma was associated with the only non-survivor in the study, while penetrating and other injury types were linked exclusively to survivors.

Conclusion: The TRISS score was the most reliable tool for predicting survival outcomes among trauma patients in this study, with borderline significance. Gender and mechanisms of injury showed potential associations with survival status, while age, NISS, and APACHE II scores were not strong predictors in this sample. Future studies with larger samples may help clarify these trends and improve predictive accuracy for trauma care.