title: Limitations of the TRISS method for interhospital comparisons: a multihospital study.
abstract: The value of the TRISS method for interhospital comparisons of trauma care was studied using data for 5,616 consecutive patients from three trauma centers and five community hospitals. Z-scores were used to compare mortality rates. Three limitations of the method were documented: 1) the lack of homogeneity within the patient subcategory of penetrating injuries, specifically between patients with gunshot versus stab wounds; 2) the inability of the TRISS method to predict the survival rate of patients suffering low falls; and 3) the inability of the TRISS method to account for multiple severe injuries to a single body part. Remedies to the first two of these limitations can be addressed within the present TRISS method. A remedy for the third requires a new method.
authors.affiliation: Institute for Trauma & Emergency Care, New York Medical College, Valhalla.
authors.forename: C G
authors.initials: CG
authors.lastname: Cayten
authors.forename: W M
authors.initials: WM
authors.lastname: Stahl
authors.forename: J G
authors.initials: JG
authors.lastname: Murphy
authors.forename: N
authors.initials: N
authors.lastname: Agarwal
authors.forename: D W
authors.initials: DW
authors.lastname: Byrne
mesh_terms: D015998:Abbreviated Injury Scale; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality; D011379:Prognosis; D015996:Survival Rate; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000401:mortality*; D014949:Wounds, Nonpenetrating / Q000401:mortality; D014950:Wounds, Penetrating / Q000401:mortality