Comparative study between AIS 1998 and AIS 2005 for evaluation of injury severity and major trauma outcome

Objective To compare the superiority of AIS 2005 and AIS 1998 for evaluation of injury severity and major trauma outcome.Methods 3110 trauma patients evaluated by AIS 2005 and AIS 1998 from January 2003 to May 2005 were analyzed retrospectively.Results The mortality and morbidity of complications in trauma patients were ascending with the increase of ISS.The ascending tendency in mortality was more notable in ISS20 in AIS 2005.The mortality in trauma patients in AIS 2005 was significantly lower than those in AIS 1998 in ISS15-≤20(P=0.001).The morbidity of complications in trauma patients in AIS 2005 was significantly lower than those in AIS 1998 in ISS≤15,the ascending tendency to morbidity of complications was more notable in other ISS groups in AIS 2005 than those in AIS 1998.RTS,TRISS,ASCOT and ASCOT-CHINA decreased with ISS ascending gradually,and the distribution of survival probability predictive value in AIS 2005 was more sensitive than those in AIS 2005.The distinctiveness and sensitivity of predictability index in AIS 2005 was higher than those in AIS 1998,and the degree of accuracy of the ASCOT and TRISS and the specificity of the ASCOT-CHINA and TRISS in AIS 2005 were higher than those in AIS 1998,and the survival miscarriage of justice ratio of the ASCOT-CHINA and TRISS in AIS 2005 was lower than that in AIS 1998,but the degree of accuracy of the ASCOT-CHINA and the specificity of the ASCOT in AIS 2005 were lower than those in AIS 1998,and the survival miscarriage of justice ratio of the ASCOT was higher than those in AIS 1998.There was superiority in AIS 2005 to the survival possibility prediction for survival and death group than in AIS 1998.Conclusion It is better by using the methods of ISS,TRISS,ASCOT to evaluate injury severity and predict major trauma outcome based on AIS 2005 than using AIS 1998.It is reasonable to definite severe trauma by ISS value greater than 20 in AIS 2005.