+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Correlation Between the Revised Trauma Score and Injury Severity Score: Implications for Prehospital Trauma Triage



Correlation Between the Revised Trauma Score and Injury Severity Score: Implications for Prehospital Trauma Triage



Prehospital Emergency Care 23(2): 263-270



Prehospital triage of the seriously injured patient is fraught with challenges, and trauma scoring systems in current triage guidelines warrant further investigation. The primary objective of this study was to assess the correlation of the physiologically based Revised Trauma Score (RTS) and MGAP score (mechanism of injury, Glasgow Coma Scale, age, blood pressure) with the anatomically based Injury Severity Score (ISS). The secondary objectives for this study were to compare the accuracy of the MGAP score and the RTS for the prediction of in-hospital mortality for trauma patients. This study was a retrospective cohort including 10 years of patient data in a large single-center trauma registry at a primary adult resource center (Level I) for trauma patients. Participants included adults (age ≥18 years). The primary outcome measure was injury severity (measured by ISS) and a secondary analysis compared the RTS and MGAP for the prediction of patient mortality. Descriptive statistics were used to describe the cohort and correlation methods were employed. Each score's accuracy for the prediction of mortality was calculated using the area under receiver operating characteristic (AUROC) curves. In total, 43,082 trauma patient records were reviewed; 32,798 patients had complete RTS data available and 32,371 patients had complete data available for MGAP analyses. The correlation between scene RTS and ISS was poor (-.29), as was the correlation between MGAP and ISS (-.28). For the prediction of mortality, admission MGAP demonstrated the highest sensitivity and specificity for mortality (AUROC 0.96; 95% CI, 0.95-0.96). While elements of the RTS remain the first criterion recommended to quantify the totality of physiological injury severity, the composite RTS score derived from this system correlates poorly with actual anatomical injury severity. The MGAP scoring system demonstrated higher sensitivity and specificity for mortality but was not superior to the RTS for predicting anatomical injury severity. In the future development of national and international field triage guidelines for trauma patients, the findings from this study may be considered in order to improve the accuracy of prehospital triage. The findings in this analysis complement a growing body of evidence that suggests that MGAP may be a superior and more easily calculable prehospital scoring system for the prediction of mortality in trauma patients.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 056973009

Download citation: RISBibTeXText

PMID: 30118369

DOI: 10.1080/10903127.2018.1489019


Related references

Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients. Indian Journal of Critical Care Medicine 23(2): 73-77, 2019

Comparison of Revised Trauma Score, Injury Severity Score and Trauma and Injury Severity Score for mortality prediction in elderly trauma patients. Ulusal Travma Ve Acil Cerrahi Dergisi 22(6): 536-540, 2016

Correlation of revised trauma score and injury severity score (TRISS) predicted probability of survival with peer-reviewed determination of trauma deaths. American Surgeon 69(3): 257, 2003

Lethal abdominal gunshot wounds at a level I trauma center: analysis of TRISS (Revised Trauma Score and Injury Severity Score) fallouts. Journal of the American College of Surgeons 187(2): 123-129, 1998

Application of "Trauma and Injury Severity Score" and "A Severity Characterization of Trauma" score to trauma patients in a setting different from "Major Trauma Outcome Study". Archives of Iranian Medicine 10(3): 383-386, 2007

Comparison of modified Kampala trauma score with trauma mortality prediction model and trauma-injury severity score: A National Trauma Data Bank Study. American Journal of Emergency Medicine 35(8): 1056-1059, 2017

The thorax trauma severity score and the trauma and injury severity score: Do they predict in-hospital mortality in patients with severe thoracic trauma?: A retrospective cohort study. Medicine 96(42): E8317, 2017

Correlation of the RTS (Revised Trauma Score) and RAPS (Rapid Acute Physiology Score) in rotor-wing prehospital care. Air Medical Journal 13(3): 91-95, 1994

Comparison of the trauma and injury severity score and modified early warning score with rapid lactate level (the ViEWS-L score) in blunt trauma patients. European Journal of Emergency Medicine 21(3): 199-205, 2014

Prehospital airway and ventilation management: a trauma score and injury severity score-based analysis. Journal of Trauma 69(2): 294-301, 2010

Improved prediction from revised injury severity classification (RISC) over trauma and injury severity score (TRISS) in an independent evaluation of major trauma patients. Journal of International Medical Research 38(4): 1530-1538, 2010

Predictors of mortality in adult trauma patients: the physiologic trauma score is equivalent to the Trauma and Injury Severity Score. Journal of the American College of Surgeons 194(6): 695-704, 2002

Evaluating performance of the revised trauma score as a triage instrument in the prehospital setting. Injury. 27(3): 163-167, 1996

Comparison of the new Exponential Injury Severity Score with the Injury Severity Score and the New Injury Severity Score in trauma patients: A cross-sectional study. Plos one 12(11): E0187871, 2017

The end of the Injury Severity Score and the Trauma and Injury Severity Score ICISS, an International Classification of Diseases, Ninth Revision-based prediction tool, outperforms both ISS and TRISS as predictors of trauma patient survival, hospital charges, and hospital length of stay. Journal of Trauma Injury Infection and Critical Care 44(1): 41-49, 1998