Evaluation of trauma care in a community hospital ICU. Comparison of TRISS and APACHE II scores

Objective: To compare the performances of the acute physiology and chronic health evaluation score (APACHE II) and the trauma-injury severity score (TRISS) on our intensive care unit (ICU) trauma patients. Setting: A six-bedded general ICU in a 500-bed community hospital. Design: Prospective, cohort study of consecutive admissions to the ICU following trauma. Subjects: One hundred and ninety severe trauma patients admitted from January 1992 to December 1993 were considered eligible. Patients in whom the hospital outcome was unknown were excluded. One hundred and sixty-two patients with known hospital outcome had complete TRISS data, while 108 of them also had complete APACHE II data. Outcome measure: Vital status at discharge from the last hospital that admitted the trauma patient. Methods: The APACHE II score and TRISS method were compared by using the Hosmer-Lemeshow goodness-of-fit statistics, receiver-operating characteristic (ROC) curve analysis and likelihood ratios. Results: The Hosmer-Lemeshow goo...