Citation

Schluter PJ, Cameron CM, Davey TM, Civil I, Orchard J, Dansey R, Hamill J, Naylor H, James C, Dorrian J, Christey G, Pollard C, McClure RJ. N. Zeal. Med. J. 2009; 122(1302): 65-78.

Affiliation

School of Public Health and Psychosocial Studies, AUT University, Auckland, New Zealand. philip.schluter@aut.ac.nz

Copyright

(Copyright © 2009, New Zealand Medical Association)

DOI

unavailable

PMID

19834524

Abstract

AIM: To develop and assess the predictive capabilities of a statistical model that relates routinely collected Trauma Injury Severity Score (TRISS) variables to length of hospital stay (LOS) in survivors of traumatic injury. METHOD: Retrospective cohort study of adults who sustained a serious traumatic injury, and who survived until discharge from Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Cubic-root transformed LOS was analysed using two-level mixed-effects regression models. RESULTS: 1498 eligible patients were identified, 1446 (97%) injured from a blunt mechanism and 52 (3%) from a penetrating mechanism. For blunt mechanism trauma, 1096 (76%) were male, average age was 37 years (range: 15-94 years), and LOS and TRISS score information was available for 1362 patients. Spearman's correlation and the median absolute prediction error between LOS and the original TRISS model was p=0.31 and 10.8 days, respectively, and between LOS and the final multivariable two-level mixed-effects regression model was p=0.38 and 6.0 days, respectively. Insufficient data were available for the analysis of penetrating mechanism models. CONCLUSIONS: Neither the original TRISS model nor the refined model has sufficient ability to accurately or reliably predict LOS. Additional predictor variables for LOS and other indicators for morbidity need to be considered.

Language: en