VALIDATION OF TRISS AND ASCOT USING A NON-MTOS TRAUMA REGISTRY

Objectives: To validate the Trauma and Injury Severity Score (TRISS) a nd A Severity Characterization of Trauma (ASCOT) models for patients w ith blunt injuries using an independent trauma registry, and to develo p new TRISS and ASCOT models for types of patients with blunt injuries and examine their fit. Design: Retrospective analysis of clinical dat a from the Institute for Trauma and Emergency Care OTEC). Materials an d Methods: Statistical models were developed using TRISS and ASCOT var iables applied to ITEC data for patients with blunt injuries, These mo dels were compared to Major Trauma Outcome Study (MTOS) models with re gard to the resulting coefficients and hospital quality assessments, A lso, separate models were developed for different groups of blunt inju ries, and these models were compared with one another and tested for a dequacy of fit. Measurements and Main Results: ASCOT performed accepta bly well when new coefficients were derived using ITEC data, but TRISS did not, Although the models developed from MTOS and from ITEC coeffi cients generally yielded similar hospital quality assessments, there w ere some notable exceptions, Some TRISS and ASCOT variables were not s ignificantly related to survival for some subgroups of blunt injuries, and neither the TRISS nor the ASCOT model was an adequate predictor o f survival for patients suffering from low falls. Conclusions: New TRI SS and ASCOT coefficients should be derived if survival for patients w ith blunt injuries is to be predicted accurately in independent trauma registries, Also, it may be wise to consider developing separate mode ls for subgroups of patients, particularly if hospitals in the registr y have different mixes of patient types.