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Comparative Study
. 2004 Jun;56(6):1312-20.
doi: 10.1097/01.ta.0000075342.36072.ef.

The New Injury Severity Score: a more accurate predictor of in-hospital mortality than the Injury Severity Score

André Lavoie  1 , Lynne Moore, Natalie LeSage, Moishe Liberman, John S Sampalis
Affiliations
Comparative Study

The New Injury Severity Score: a more accurate predictor of in-hospital mortality than the Injury Severity Score

André Lavoie et al. J Trauma. 2004 Jun.

Abstract

Objective: The purpose of this study was to determine whether the New Injury Severity Score (NISS) is a better predictor of mortality than the Injury Severity Score (ISS) in general and in subgroups according to age, penetrating trauma, and body region injured.

Methods: The study population consisted of 24,263 patients from three urban Level I trauma centers in the province of Quebec, Canada. Discrimination and calibration of NISS and ISS models were compared using receiver operator characteristic (ROC) curves and Hosmer-Lemeshow statistics.

Results: NISS showed better discrimination than ISS (area under the ROC curve = 0.827 vs. 0.819; p = 0.0006) and improved calibration (Hosmer-Leme-show = 62 vs. 112). The advantage of the NISS over the ISS was particularly evident among patients with head/neck injuries (area under the ROC curve = 0.819 vs. 0.784; p < 0.0001; Hosmer-Lemeshow = 59 vs. 350).

Conclusion: The NISS is a more accurate predictor of in-hospital death than the ISS and should be chosen over the ISS for case-mix control in trauma research, especially in certain subpopulations such as head/neck-injured patients.

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