IMPROVED PREDICTION FROM A REVISED INJURY SEVERITY CLASSIFICATION (RISC) OVER TRAUMA AND INJURY SEVERITY SCORE (TRISS) OF AN INDEPENDENT EVALUATION OF MAJOR TRAUMA PATIENTS

Background Celje General Hospital started implementing a polytrauma registry in 1992 to collect the data for comparison of treatment efficacy with international standards. The quality of treatment was evaluated with TRISS, but structural differences to MTOS study significantly impacted obtained results. At 2006 they started adding data to DGU Traumaregister where quality of treatment was evaluated with RISC. The aim of the study was to assess the usefulness of the RISC analysis for the evaluation of the quality of treatment of severely injured patients and to compare it with TRISS. Methods The cohort of 155 major trauma patients treated in the Celje General Hospital in the years 2006-2007 was included in DGU Traumaregister. The structure of patients was compared to the registry and TRISS and RISC analyses were performed. M-statistic was used to compare the distribution of injury severity between groups, TRISS and RISC were evaluated with ROC curves and the Hosmer-Lemeshow test. Results M-statistic (0.83) showed a good match of probability of survival between groups. Moreover, RISC evaluation (AUC 0.94), H-L test (3.5, p = 0.94) proved the efficacy of this method. The TRISS with AUC 0.89 and H-L test 21.1 was not reliable tool for comparing outcomes between groups. Conclusions RISC demonstrated very good performance and should replace TRISS in the evaluation of treatment in major trauma patient population.