The Relationship Between Trauma Scoring Systems and Outcomes in Patients With Severe Traumatic Brain Injury

Overview

Journal Korean J Neurotrauma

Date 2022 Nov 16

PMID 36381431

Authors

Tae Seok Jeong

Dae Han Choi

Woo Kyung Kim

Affiliations

Soon will be listed here.

Abstract

Objective: This study investigated the relationship between trauma scoring systems and outcomes in patients with severe traumatic brain injury (TBI).

Methods: From January 2018 to June 2021, 1,122 patients with severe TBI were registered in the Korean Neuro-Trauma Data Bank System. Among them, 697 patients with data on trauma scoring systems were included in the study. According to the Glasgow Outcome Scale-Extended score, the patients were divided into unfavorable and favorable outcome groups. The abbreviated injury scale (AIS), injury severity score (ISS), revised trauma score (RTS), and trauma and injury severity score (TRISS) were evaluated.

Results: The AIS head score was higher in the unfavorable outcome group than in the favorable outcome group (4.39 vs. 4.06, <0.001). ISS was also higher in the unfavorable outcome group (27.27 vs. 24.22, =0.001). The RTS and TRISS were higher in the favorable outcome group (RTS, 4.74 vs. 5.45, <0.001; TRISS, 48.05 vs. 71.02, <0.001). In comparing the survival and death groups, the ISS was lower in the survival group (25.76 vs. 27.29, =0.036). Furthermore, RTS was higher in the survival group (5.26 vs. 4.54, <0.001), as was TRISS (62.11 vs. 44.91, <0.001).

Conclusion: Trauma scoring systems, including ISS, RTS, and TRISS, provide tools for quantifying posttraumatic risk and can be used to predict prognosis. Among these, TRISS is an indicator of the predicted survival rate and is considered a clinically useful tool for predicting unfavorable and favorable outcomes in patients with severe TBI.

Citing Articles

External validation of an artificial intelligence model using clinical variables, including ICD-10 codes, for predicting in-hospital mortality among trauma patients: a multicenter retrospective cohort study.

Lee S, Kim D, Oh N, Lee H, Park S, Yon D Sci Rep. 2025; 15(1):1100.

PMID: 39775076 PMC: 11707174. DOI: 10.1038/s41598-025-85420-5.

Geriatric Trauma Outcome Score for Predicting Mortality among Older Korean Adults with Trauma: Is It Applicable in All Cases?.

Han J, Yoon S, Seok J, Lee J, Lee J, Ye J Ann Geriatr Med Res. 2024; 28(4):484-490.

PMID: 39192823 PMC: 11695760. DOI: 10.4235/agmr.24.0095.

Epidemiology and Outcomes of Severe Traumatic Brain Injury: Regional Trauma Center in Incheon, Korea, 2018-2022.

Hwang I, Jeong T, Kim W, Kim J, Jang M Korean J Neurotrauma. 2024; 20(1):17-26.

PMID: 38576499 PMC: 10990697. DOI: 10.13004/kjnt.2024.20.e9.

References

Osler T, Rutledge R, Deis J, Bedrick E . ICISS: an international classification of disease-9 based injury severity score. J Trauma. 1996; 41(3):380-6; discussion 386-8. DOI: 10.1097/00005373-199609000-00002. View

. Rating the severity of tissue damage. I. The abbreviated scale. JAMA. 1971; 215(2):277-80. DOI: 10.1001/jama.1971.03180150059012. View

Susman M, DiRusso S, Sullivan T, Risucci D, Nealon P, Cuff S . Traumatic brain injury in the elderly: increased mortality and worse functional outcome at discharge despite lower injury severity. J Trauma. 2002; 53(2):219-23; discussion 223-4. DOI: 10.1097/00005373-200208000-00004. View

Kim S, Chae S . Promising candidate cerebrospinal fluid biomarkers of seizure disorder, infection, inflammation, tumor, and traumatic brain injury in pediatric patients. Clin Exp Pediatr. 2021; 65(2):56-64. PMC: 8841973. DOI: 10.3345/cep.2021.00241. View

Steyerberg E, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh G . Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics. PLoS Med. 2008; 5(8):e165. PMC: 2494563. DOI: 10.1371/journal.pmed.0050165. View

Bedell E, Prough D . Anesthetic management of traumatic brain injury. Anesthesiol Clin North Am. 2002; 20(2):417-39. DOI: 10.1016/s0889-8537(01)00010-4. View

Champion H, Copes W, Sacco W, Lawnick M, Keast S, Bain Jr L . The Major Trauma Outcome Study: establishing national norms for trauma care. J Trauma. 1990; 30(11):1356-65. View

Gennarelli T, Wodzin E . AIS 2005: a contemporary injury scale. Injury. 2006; 37(12):1083-91. DOI: 10.1016/j.injury.2006.07.009. View

Schluter P, Nathens A, Neal M, Goble S, Cameron C, Davey T . Trauma and Injury Severity Score (TRISS) coefficients 2009 revision. J Trauma. 2010; 68(4):761-70. DOI: 10.1097/TA.0b013e3181d3223b. View

10.

Maas A, Hukkelhoven C, Marshall L, Steyerberg E . Prediction of outcome in traumatic brain injury with computed tomographic characteristics: a comparison between the computed tomographic classification and combinations of computed tomographic predictors. Neurosurgery. 2005; 57(6):1173-82. DOI: 10.1227/01.neu.0000186013.63046.6b. View

11.

Boyd C, Tolson M, Copes W . Evaluating trauma care: the TRISS method. Trauma Score and the Injury Severity Score. J Trauma. 1987; 27(4):370-8. View

12.

Baker S, ONeill B, HADDON Jr W, Long W . The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974; 14(3):187-96. View

13.

Champion H, Sacco W, CARNAZZO A, Copes W, FOUTY W . Trauma score. Crit Care Med. 1981; 9(9):672-6. DOI: 10.1097/00003246-198109000-00015. View

14.

Berry C, Ley E, Bukur M, Malinoski D, Margulies D, Mirocha J . Redefining hypotension in traumatic brain injury. Injury. 2011; 43(11):1833-7. DOI: 10.1016/j.injury.2011.08.014. View

15.

Eom K, Kim J, Yoon S, Lee S, Park K, Ha S . Gender differences in adult traumatic brain injury according to the Glasgow coma scale: A multicenter descriptive study. Chin J Traumatol. 2021; 24(6):333-343. PMC: 8606602. DOI: 10.1016/j.cjtee.2021.06.004. View

16.

Munivenkatappa A, Agrawal A, Shukla D, Kumaraswamy D, Devi B . Traumatic brain injury: Does gender influence outcomes?. Int J Crit Illn Inj Sci. 2016; 6(2):70-3. PMC: 4901830. DOI: 10.4103/2229-5151.183024. View

17.

Champion H, Sacco W, Copes W, GANN D, Gennarelli T, Flanagan M . A revision of the Trauma Score. J Trauma. 1989; 29(5):623-9. DOI: 10.1097/00005373-198905000-00017. View

18.

Spaite D, Hu C, Bobrow B, Chikani V, Barnhart B, Gaither J . The Effect of Combined Out-of-Hospital Hypotension and Hypoxia on Mortality in Major Traumatic Brain Injury. Ann Emerg Med. 2016; 69(1):62-72. PMC: 5173421. DOI: 10.1016/j.annemergmed.2016.08.007. View

19.

Jiang J, Gao G, Li W, Yu M, Zhu C . Early indicators of prognosis in 846 cases of severe traumatic brain injury. J Neurotrauma. 2002; 19(7):869-74. DOI: 10.1089/08977150260190456. View