Analysis of Trauma Outcome Using the TRISS Method at a Tertiary Care Centre in Pune

Out of the various systems used to assess the outcome of polytrauma patients, trauma and injury severity score (TRISS) is considered as the standard tool for evaluating the performance of trauma centres. The present study was carried out to evaluate the outcome of severely injured patients using the TRISS method in a developing country like India and to compare it with the major trauma outcome study (MTOS). A prospective study of 300 patients of trauma was done. Outcome assessment was done for the severely injured patients using the TRISS method. Road traffic accidents (213 cases) were the most common cause of injury. Fifty-seven (19%) cases were severely injured defined as having an injury severity score a parts per thousand yen16. Outcome assessment was done for these patients using the TRISS method. The predicted mortality was 15.7%, while the observed mortality was 33.3%. The mean revised trauma score was 6.63 +/- 1.79 and the mean injury severity score (ISS) was 23.7 +/- 8.17. Compared to the MTOS, the patients in the present study had more severe injuries with higher mortality. The present method of comparison of trauma care, i.e. TRISS which uses the MTOS coefficients, does not accurately predict survival of trauma patients in the developing countries as indicated by the present and other studies. There is a need for developing a national trauma registry to derive new coefficients for trauma scoring for the Indian subcontinent so that the quality of trauma care can be compared with that in the developed countries.