CORRELATION OF TRAUMA SCORING AND OUTCOME IN A CANADIAN TRAUMA CENTER

Objective: To study the effectiveness of treatment and the outcome in trauma patients, and to correlate these with trauma scoring systems. D esign: A prospective study over 1 year of the probability of survival after trauma, based on TRISS methodology. A computerized database prov ided outcome statistics. Setting. A regional trauma centre in a Canadi an university' teaching hospital serving regional and referral patient s. Patients: Three hundred consecutive patients treated at a single tr auma unit. Two patients were excluded because of lack of physiologic d ata. Blunt injuries (94%) were most frequently from motor vehicle acci dents (46%). Interventions: Those appropriate to multidisciplinary tra uma management in a level 1 trauma centre. Main Outcome Measures: Surv ival (Z values) and injury severity (M values) for the total group and subsets were calculated for comparison of outcomes with the Multiple Trauma Outcome Study baseline and other Canadian centres for multisyst em and single-system injuries. Results: The mean Injury Severity Score was 21.16 and the mean Revised Trauma Score was 6.75. There were 51 ( 17%) deaths - a Z value for the study group of 2.26. The M value was 0 .78. Forty of the 51 single-system injuries were head injuries and acc ounted for 15 deaths. The Z value for multisystem injuries only was 0. 54, and the M value was 0.77. Conclusions. The TRISS method for analys ing blunt trauma is comparable to other trauma scoring systems. The co rrelation of outcome analysis with other scoring systems is affected b y exclusion rates, prereferral resuscitation and single- versus multip le-injury mix of cases.