[Measuring severity in trauma resuscitation].
ISS is the most widely used anatomic trauma severity index. This scale uses clinical judgement. It is therefore a subjective method, the validity of which is somewhat questionable. The aim of this study was to compare the clinical index ISS with a new non-specific score; the "simplified acute physiology score" (SAPS). Five-hundred trauma patients were checked retrospectively. Were excluded small traumas which did not require ICU hospitalization. ISS were all calculated by the same specialist and SAPS was drawn out of the initial blood sample examination. The sensitivity (proportion of true positive) and the specificity (proportion of true negative) were calculated for the two scores at all different cut-off points. "Receiver operating characteristic curves" (ROC) were drawn and their areas were compared by means of the Hanley test. The best Youden index, i.e. the fewest false positives for the most true positives, was also calculated. Mean ISS was 23.3 +/- 9.2. Youden index was 0.1; sensitivity and specificity were respectively 57 and 52% for the cut-off points. Mean SAPS was 8.7 +/- 4.3. Youden index was 0.3 and sensitivity and specificity were respectively 68 and 62%. ROC curve area for SAPS was 0.69 +/- 0.02. ROC curve area for ISS was 0.56 +/- 0.03 (p = 0.0001). In trauma, SAPS seemed to be a better predictor of outcome than ISS.
D005069:Evaluation Studies as Topic; D006801:Humans; D008722:Methods; D012151:Resuscitation; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology
Mesure de la gravité en réanimation traumatologique.