title: Value of anatomic and physiologic scoring systems in outcome prediction of trauma patients.
abstract: OBJECTIVE
  The goal of this study was to compare the prediction performance of two anatomic scales, the Injury Severity Scale (ISS) and the New Injury Severity Scale (NISS), with two physiologic scales, the Revised Trauma Scale (RTS) and the Simplified Acute Physiology Scale II (SAPS II), in trauma patients.
  
  
  METHODS
  Prospective study carried out over a 16-month period.
  
  
  METHODS
  Emergency department of a teaching hospital.
  
  
  METHODS
  Hospitalized victims of trauma up to 14 years of age.
  
  
  METHODS
  The primary endpoint was the survival status at hospital discharge; the secondary outcome was need for ICU admission. Model discrimination was evaluated by the area under the receiver-operating characteristic curve and model calibration was evaluated using the Hosmer-Lemeshow goodness-of-fit statistic.
  
  
  RESULTS
  A total of 1136 patients, with an average age of 37.6 years, fulfilled the inclusion criteria. The mortality rate was 4.5%. The combined rate of hospital death and ICU admission was 17.3%. The ISS and the NISS showed excellent discriminative power for mortality prediction (AUC 0.94 and 0.93, respectively) and ICU admission decision (0.91 and 0.89, respectively), and a good calibration. The SAPS II and the RTS showed lower discriminative power. Combining ISS or NISS with SAPS II did not improve significantly the predictive performance of each scale alone.
  
  
  CONCLUSIONS
  Both ISS and NISS showed better predictive severity performance compared with RTS and SAPS II in trauma patients. The combination of anatomic scales with physiologic ones did not improve the prediction performance of each scale considered alone.
authors.affiliation: aDepartment of Anesthesiology and Surgical Intensive Care Unit bEmergency Department and Research Unit UR06SP21, Fattouma Bourguiba University Hospital cDepartment of Medicine, Faculty of Medicine, University of Monastir, Monastir, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Kahloul
authors.forename: Wahid
authors.initials: W
authors.lastname: Bouida
authors.forename: Hamdi
authors.initials: H
authors.lastname: Boubaker
authors.forename: Semir
authors.initials: S
authors.lastname: Toumi
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Grissa
authors.forename: Amira
authors.initials: A
authors.lastname: Jaafar
authors.forename: Moez
authors.initials: M
authors.lastname: Louzi
authors.forename: Riadh
authors.initials: R
authors.lastname: Boukef
authors.forename: Mourad
authors.initials: M
authors.lastname: Gahbiche
authors.forename: Semir
authors.initials: S
authors.lastname: Nouira
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000401:mortality