Retrospective evaluation of the simplified Therapeutic Intevention ScoringSystem (TISS-28) in a surgical intensive care unit

Objective: To compare the simplified Therapeutic Intervention Scoring Syste m (TISS-28) with its original version, to provide reference values of daily TISS-28 assessment and to describe its association with severity of illnes s in surgical patients. Design: Retrospective evaluation of prospectively collected audit data; fou r documentation periods. Setting: Ten-bed intensive care unit (ICU) in a surgical university hospita l. Patients: One thousand nine hundred eighty-six consecutive admissions (1,80 8 patients; 10,448 observation days) who stayed on ICU for at least 6 h. Pa tients were in hospital for abdominal, vascular or trauma surgery. The aver age age was 61.5 years, the mean APACHE II score on admission 10.3 points. Interventions: None. Measurements: Raw data for APACHE Lf score and TISS were recorded daily. TI SS-28 was calculated retrospectively from the original TISS data. Results: Average TISS-28 values (28.7 points; SD = 9.7) do not differ subst antially from the original TISS values (28.2 points, SD = 10.9) and overall correlation is high (r = 0.935). Of the patients, 57.3 % left the ICU afte r 1-2 days as survivors with a mean daily TISS-28 of 20.0 points. Variabili ty between documentation periods was higher with the original TISS. On aver age, patients with increasing severity of disease require an increasing amo unt of care. Survivors have lower TISS-28 values than non-survivors (27.6 v s 34.9). Conclusions: In a surgical ICU the simplified version of TISS with 28 items (TISS-28) sufficiently reflects the amount of intensive care provided and may provide useful additional information on severity of disease and progno sis. It should replace the original index, at least in these cases.