War head injury score: an outcome prediction model in War casualties with acute penetrating head injury.
OBJECTIVE
To evaluate in war casualties with acute penetrating head injury whether the summed War Head Injury Score (WHIS) is a better predictor of mortality than either the Glasgow Coma Scale (GCS) score or the Injury Severity Score (ISS) alone and to establish its specific applicability.


METHODS
Sensitivity, specificity, correct outcome prediction, and discrimination were assessed in 43 patients in the war group (ballistic injuries) and 41 patients in the civil group (nonballistic injuries) during the period 1991 to 1995. The new model was generated using the sum of GCS scores and ISS, to which a coded value was applied for summation.


RESULTS
In the war group, the mortality rate was 23%; the sensitivity and specificity of WHIS were 100% and 79%, the sensitivity and specificity of GCS score were 90% and 85%, and the sensitivity and specificity of ISS were 100% and 49%, respectively. In the civil group, the mortality rate was 39%; the sensitivity and specificity of WHIS were 87% and 76%, the sensitivity and specificity of GCS score were 63% and 90%, and the sensitivity and specificity of ISS were 100% and 56%, respectively.


CONCLUSIONS
With regard to civilians, war casualties with acute penetrating head injury more often have multiple injuries. WHIS represents a new scoring system that incorporates both GCS score and ISS.
Turina
D
D
Department of Anesthesiology and Intensive Care Unit, Clinical Hospital Rijeka, Rijeka, Croatia.
Sustić
A
A
Tićac
Z
Z
Dirlić
A
A
Krstulović
B
B
Glavas
A
A
Orlić
V
V
D000328:Adult; D016022:Case-Control Studies; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000401:mortality; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D012372:ROC Curve; D012680:Sensitivity and Specificity; D015599:Trauma Severity Indices; D014857:Warfare; D014948:Wounds, Gunshot / Q000175:diagnosis* / Q000401:mortality