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J Korean Soc Emerg Med > Volume 6(2); 1995 > Article
Journal of The Korean Society of Emergency Medicine 1995;6(2): 357-364.
COMPARISON BETWEEN TRISS AND ASCOT METHODS IN MULTIPLE TRAUMA PATIENTS
Hyuk Jun Yang1, Hyung Soo Kim1, Sung Man Bae1, Cheol Wan Park1, Keun Lee1, Young Kwan Ko2
1Department of Emergency Medicine, Chung Ang Gil Hospital
2Department of Surgery, College of Medicine, Kyung Hee University·
  Published online: December 31, 1995.
ABSTRACT
Despite traumatic injuries cause serious problems in our society, there are few adequate and objective scoring system that assess the severity of trauma patients. The Major Trauma Outcome Study(MTOS) in United States designed the TRISS(Trauma Score & Injury Severity Score) method by means of Revised Trauma Score(RTS), Injury Severity Score(ISS), and age, while Champion et al deviced ASCOT(A Severity Characterization Of Trauma) method to overcome the limitation of TRISS. This study attempted to make a comparison between TRISS and ASCOT by using data for 442 injured patients which were collected from Emergency center of Chung Ang Gil Hospital and Kyung Hee University Medical Center from September, 1993 to February, 1994. ASCOT and TRISS were compared in their sensitivity, specificity, disparity and Z-statistics. The results were as follows : 1) Sex ratio of male to female was 2.8:1 and the commonest age of trauma patients was thirties (23.8%). 2) The average probability of survival(Ps) for 442 patient by TRISS method was 0.9228 and that of ASCOT method 0.9356. 3) Disparity of Ps between survival and non-survival using TRISS and ASCOT was relatively low for both indexes as 0.3507 and 0.3293, respectively. 4) The sensitivity rates(number of patients predicted to die who actually died/total who actually died) for the non-survival of both TRISS and ASCOT method were low (35.0%), but the specificity rates(number of patients predicted to live who actually lived/total who actually lived) for the survival of TRISS and ASCOT were 99.1% and 99.6% respectively. 5) Z-statistics(difference between predicted and actual number of death) of both TRISS(1.3224) and ASCOT(1.2234) resulted in positive value which meant that actual number of death exeeded predicted number of death. 6) The ASCOT that have presumed to be more accurate method for patients with head trauma and with multiple injuries to one portion of body, had its intricacy and difficult points in practical application. And the difference between the result of ASCOT and TRISS was not so significant. 7) It is thought that a new, more comprehensive index would like to be developed and thoroughly tested on a variety of data sets in order for it to be used in trauma system quality assurance evaluation.
Key words: Ps · TRISS · ASCOT
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