Development and validation of the revised injury severity classification score for severely injured patients

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Rolf Lefering

Abstract

Trauma scores are often used for prognostication and the adjustment of mortality data. The appropriate consideration of identified prognostic factors is mandatory for a valid score with good outcome prediction properties. The Trauma Registry of the German Society for Trauma Surgery (TR-DGU) initially used the Trauma and Injury Severity Score (TRISS) but various reasons led to the development of a new scoring system, the Revised Injury Severity Classification (RISC). A total of 2,008 severely injured patients with complete data documented in the TR-DGU during the period 1993-2000 were used to develop a new score. Patients were split into a development sample (n = 1,206) and a validation sample (n = 802). Multivariate logistic regression analysis was applied, and the results were compared with existing score systems. The quality of prediction was determined regarding discrimination (disparity, sensitivity, specificity, receiver operating characteristic [ROC] curve), precision (predicted versus observed mortality), and calibration (Hosmer-Lemeshow goodness-of-fit). Existing score systems (ISS, NISS, RTS, ASCOT, TRISS, Rixen) revealed areas under the ROC curve ranging from 0.767 to 0.877. The RISC combines 11 different components: ...Continue Reading

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Citations

Mar 16, 2012·Der Unfallchirurg·C KleberUNKNOWN DGU TraumaRegister
Aug 19, 2011·Langenbeck's Archives of Surgery·Matthias HeuerUNKNOWN Trauma Registry of the DGU
May 13, 2010·Journal of Trauma Management & Outcomes·Karl-Georg KanzUNKNOWN Trauma Registry of the German Trauma Society
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May 28, 2014·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·R LeferingU Nienaber

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