Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep;24(5):261-265.
doi: 10.1016/j.cjtee.2021.01.006. Epub 2021 Jan 19.

New injury severity score (NISS) outperforms injury severity score (ISS) in the evaluation of severe blunt trauma patients

Hui Li  1 , Yue-Feng Ma  2
Affiliations

New injury severity score (NISS) outperforms injury severity score (ISS) in the evaluation of severe blunt trauma patients

Hui Li et al. Chin J Traumatol. 2021 Sep.

Abstract

Purpose: The injury severity score (ISS) and new injury severity score (NISS) have been widely used in trauma evaluation. However, which scoring system is better in trauma outcome prediction is still disputed. The purpose of this study is to evaluate the value of the two scoring systems in predicting trauma outcomes, including mortality, intensive care unit (ICU) admission and ICU length of stay.

Methods: The data were collected retrospectively from three hospitals in Zhejiang province, China. The comparisons of NISS and ISS in predicting outcomes were performed by using receiver operator characteristic (ROC) curves and Hosmer-Lemeshow statistics.

Results: A total of 1825 blunt trauma patients were enrolled in our study. Finally, 1243 patients were admitted to ICU, and 215 patients died before discharge. The ISS and NISS were equivalent in predicting mortality (area under ORC curve [AUC]: 0.886 vs. 0.887, p = 0.9113). But for the patients with ISS ≥25, NISS showed better performance in predicting mortality. NISS was also significantly better than ISS in predicting ICU admission and prolonged ICU length of stay.

Conclusion: NISS outperforms ISS in predicting the outcomes for severe blunt trauma and can be an essential supplement of ISS. Considering the convenience of NISS in calculation, it is advantageous to promote NISS in China's primary hospitals.

Keywords: Injury severity score; Intensive care units; Mortality; New injury severity score.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that they have no conflict of interest.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Rapsang A.G., Shyam D.C. Scoring systems of severity in patients with multiple trauma. Cirugía Española (English Edition) 2015;93:213–221. doi: 10.1016/j.cireng.2013.12.031. - DOI - PubMed
    1. Baker S.P., O’Neill B., Haddon W.J. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14:187–196. doi: 10.1097/00005373-197403000-00001. - DOI - PubMed
    1. Eid H.O., Abu-Zidan F.M. New Injury Severity Score is a better predictor of mortality for blunt trauma patients than the Injury Severity Score. World J Surg. 2015;39:165–171. doi: 10.1007/s00268-014-2745-2. - DOI - PubMed
    1. Kuo S.C.H., Kuo P., Chen Y. Comparison of the new exponential injury severity score with the injury severity score and the new injury severity score in trauma patients: a cross-sectional study. PloS One. 2017;12 doi: 10.1371/journal.pone.0187871. - DOI - PMC - PubMed
    1. Osler T., Baker S.P., Long W. A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma. 1997;43:922. doi: 10.1097/00005373-199712000-00009. - DOI - PubMed