Ignite Creation Date:
2024-10-25 @ 8:05 PM
Last Modification Date:
2024-10-26 @ 3:43 PM
Study NCT ID:
NCT06653816
Status:
NOT_YET_RECRUITING
Last Update Posted:
None
First Post:
2024-10-21
Brief Title:
Comparing Exponential Injury Severity Score EISS with Injury Severity Score ISS and New Injury Severity Score NISS
Sponsor:
None
Organization:
None
Study Overview
Official Title:
Comparing the New Exponential Injury Severity Score EISS with the Injury Severity Score ISS and the New Injury Severity Score NISS in Polytrauma Patients for Survival Prediction and ICU Admission in Assiut University Hospitals
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Trauma is defined as a physical injury from an external source of sudden onset and severity which require immediate medical attention Polytrauma is a short verbal equivalent commonly used for severely injured patients usually with associated injury ie two or more severe injuries in at least two different areas of the body less often with a multiple injury ie two or more severe injuries in one body area Polytrauma patients usually have a much higher risk of mortalities and disabilities than the risk of expected mortalities in individual injuries patients
Despite improvements in trauma systems worldwide trauma continues to be one of the leading causes of death and disability in all age groups especially the young and middle age group Approximately 58 million people die each year due to trauma related injuries representing 8 of the worldwide mortality
For studying the outcomes of trauma accurate and reliable methodological tools are required for appropriate scoring of severity and outcome prediction
Trauma scores were designed to facilitate the triage of patients in the Emergency Room ER and identify patients with Polytrauma with low chances of survival Those scores were meant to organize and improve the quality of trauma care systems and to assess resources allocation
Trauma patients present to the emergency department ED with a great variety of injuries and diseases To address these the Abbreviated Injury Scale AIS system defines the severity of injury throughout the different regions of the body It is an anatomically based consensus derived global severity scoring system that classifies an individual injury by body region according to its relative severity on a 6-point scale 1 minor and 6 maximal The system is constantly revised expanded and improved and the Association for the Advancement of Automotive Medicine recently announced its latest revision the AIS 2005-Update 2008 and AIS 2015 To summarize a single patients multiple injures into a single score the Injury Severity Score ISS was created by Baker et al in 1974 which has been considered the gold standard among anatomic injury severity indicators It is based on the AIS severity values that is the summation of the squares of the severity digit in the AIS of the most severe injuries in three of six predefined body regions
However the ISS only includes one injury in each body region which leads to possible inclusion of a less severe injury in other body regions rather than another serious injury in the same body region To overcome this limitation a modified ISS the New Injury Severity Score NISS was introduced by Osler et al in 1997 NISS is simply the sum of squares of the three most severe injuries regardless of the body regions injured
Further Wang et al have created the Exponential Injury Severity Score EISS in 2014 by modifying the AIS system The EISS was computed as the simple change in AIS values by raising each AIS severity score 1-6 by 3 taking a power of AIS minus 2 and then summing the three most severe scores ie highest AIS values regardless of body regions With this exponential transformation of the AIS values the EISS is expected to be more reflective of the true severity of injuries in a patient with polytrauma In Wangs study the EISS is reported to be more predictive of survival therefore it might be used as the standard summary measure of human trauma
Despite improvements in trauma systems worldwide trauma continues to be one of the leading causes of death and disability in all age groups especially the young and middle age group Approximately 58 million people die each year due to trauma related injuries representing 8 of the worldwide mortality
For studying the outcomes of trauma accurate and reliable methodological tools are required for appropriate scoring of severity and outcome prediction
Trauma scores were designed to facilitate the triage of patients in the Emergency Room ER and identify patients with Polytrauma with low chances of survival Those scores were meant to organize and improve the quality of trauma care systems and to assess resources allocation
Trauma patients present to the emergency department ED with a great variety of injuries and diseases To address these the Abbreviated Injury Scale AIS system defines the severity of injury throughout the different regions of the body It is an anatomically based consensus derived global severity scoring system that classifies an individual injury by body region according to its relative severity on a 6-point scale 1 minor and 6 maximal The system is constantly revised expanded and improved and the Association for the Advancement of Automotive Medicine recently announced its latest revision the AIS 2005-Update 2008 and AIS 2015 To summarize a single patients multiple injures into a single score the Injury Severity Score ISS was created by Baker et al in 1974 which has been considered the gold standard among anatomic injury severity indicators It is based on the AIS severity values that is the summation of the squares of the severity digit in the AIS of the most severe injuries in three of six predefined body regions
However the ISS only includes one injury in each body region which leads to possible inclusion of a less severe injury in other body regions rather than another serious injury in the same body region To overcome this limitation a modified ISS the New Injury Severity Score NISS was introduced by Osler et al in 1997 NISS is simply the sum of squares of the three most severe injuries regardless of the body regions injured
Further Wang et al have created the Exponential Injury Severity Score EISS in 2014 by modifying the AIS system The EISS was computed as the simple change in AIS values by raising each AIS severity score 1-6 by 3 taking a power of AIS minus 2 and then summing the three most severe scores ie highest AIS values regardless of body regions With this exponential transformation of the AIS values the EISS is expected to be more reflective of the true severity of injuries in a patient with polytrauma In Wangs study the EISS is reported to be more predictive of survival therefore it might be used as the standard summary measure of human trauma
Detailed Description:
Trauma is defined as a physical injury from an external source of sudden onset and severity which require immediate medical attention Polytrauma is a short verbal equivalent commonly used for severely injured patients usually with associated injury ie two or more severe injuries in at least two different areas of the body less often with a multiple injury ie two or more severe injuries in one body area Polytrauma patients usually have a much higher risk of mortalities and disabilities than the risk of expected mortalities in individual injuries patients
Despite improvements in trauma systems worldwide trauma continues to be one of the leading causes of death and disability in all age groups especially the young and middle age group Approximately 58 million people die each year due to trauma related injuries representing 8 of the worldwide mortality
Even though polytrauma can occur due to different causes such as road traffic accidents fall from heights bullet injuries suicide and homicide Yet the leading cause of traumatic related causes of death worldwide is road traffic accidents Egypt has experienced an alarming increase in the burden of traumatic injuries In 2015 according to the World Health Organization Egypt had one of the highest rates of road accidents worldwide with more than 12000 fatalities each year one of the highest among Eastern Mediterranean Region EMR countries
Although 90 of worlds road trauma related fatalities occur in low- and middle-income countries Injury prevention and trauma care programs in these countries have remained deficient
For studying the outcomes of trauma accurate and reliable methodological tools are required for appropriate scoring of severity and outcome prediction Trauma scores were designed to facilitate the triage of patients in the Emergency Room ER and identify patients with Polytrauma with low chances of survival Those scores were meant to organize and improve the quality of trauma care systems and to assess resources allocation
More than 50 scoring systems have been published for the classification of trauma patients in the field emergency room and intensive care settings There are three main groups of trauma scores Anatomical Physiological and Combined scores Anatomical scores describe all the injuries recorded by clinical examination imaging surgery or autopsy and measure lesion severity ex Abbreviated Injury Scale AIS - Injury Severity Score ISS - New Injury Severity Score NISS -Organ Injury Scale OIS - Anatomic Profile -International Classification of Diseases ICD-9 Injury Severity Score ICISS Physiological scores describe changes happened due to the trauma and translated by changes in vital signs and consciousness ex Revised Trauma Score - Glasgow Coma Score - APACHE scoring Acute Physiology and Chronic Health Evaluation - APACHE I II III -Rapid Emergency Medicine Score REMS Combined scores include both anatomical and physiological criteria ex Trauma and Injury Severity Scores TRISS - A Severity Characterization of Trauma ASCOT-Kampala Trauma Score KTS
Trauma patients present to the emergency department ED with a great variety of injuries and diseases To address these the Abbreviated Injury Scale AIS system defines the severity of injury throughout the different regions of the body It is an anatomically based consensus derived global severity scoring system that classifies an individual injury by body region according to its relative severity on a 6-point scale 1 minor and 6 maximal The system is constantly revised expanded and improved and the Association for the Advancement of Automotive Medicine recently announced its latest revision the AIS 2005-Update 2008 and AIS 2015 To summarize a single patients multiple injures into a single score the Injury Severity Score ISS was created by Baker et al in 1974 which has been considered the gold standard among anatomic injury severity indicators It is based on the AIS severity values that is the summation of the squares of the severity digit in the AIS of the most severe injuries in three of six predefined body regions
However the ISS only includes one injury in each body region which leads to possible inclusion of a less severe injury in other body regions rather than another serious injury in the same body region To overcome this limitation a modified ISS the New Injury Severity Score NISS was introduced by Osler et al in 1997 NISS is simply the sum of squares of the three most severe injuries regardless of the body regions injured
Further Wang et al have created the Exponential Injury Severity Score EISS in 2014 by modifying the AIS system The EISS was computed as the simple change in AIS values by raising each AIS severity score 1-6 by 3 taking a power of AIS minus 2 and then summing the three most severe scores ie highest AIS values regardless of body regions With this exponential transformation of the AIS values the EISS is expected to be more reflective of the true severity of injuries in a patient with polytrauma In Wangs study the EISS is reported to be more predictive of survival therefore it might be used as the standard summary measure of human trauma
The aim of this study is to compare the ability of the new Exponential Injury Severity Score EISS with that of the Injury Severity Score ISS and the New Injury Severity Score NISS to identify patients at risk of in-hospital mortality or ICU admission and predict survival in Assiut University Hospitals
Despite improvements in trauma systems worldwide trauma continues to be one of the leading causes of death and disability in all age groups especially the young and middle age group Approximately 58 million people die each year due to trauma related injuries representing 8 of the worldwide mortality
Even though polytrauma can occur due to different causes such as road traffic accidents fall from heights bullet injuries suicide and homicide Yet the leading cause of traumatic related causes of death worldwide is road traffic accidents Egypt has experienced an alarming increase in the burden of traumatic injuries In 2015 according to the World Health Organization Egypt had one of the highest rates of road accidents worldwide with more than 12000 fatalities each year one of the highest among Eastern Mediterranean Region EMR countries
Although 90 of worlds road trauma related fatalities occur in low- and middle-income countries Injury prevention and trauma care programs in these countries have remained deficient
For studying the outcomes of trauma accurate and reliable methodological tools are required for appropriate scoring of severity and outcome prediction Trauma scores were designed to facilitate the triage of patients in the Emergency Room ER and identify patients with Polytrauma with low chances of survival Those scores were meant to organize and improve the quality of trauma care systems and to assess resources allocation
More than 50 scoring systems have been published for the classification of trauma patients in the field emergency room and intensive care settings There are three main groups of trauma scores Anatomical Physiological and Combined scores Anatomical scores describe all the injuries recorded by clinical examination imaging surgery or autopsy and measure lesion severity ex Abbreviated Injury Scale AIS - Injury Severity Score ISS - New Injury Severity Score NISS -Organ Injury Scale OIS - Anatomic Profile -International Classification of Diseases ICD-9 Injury Severity Score ICISS Physiological scores describe changes happened due to the trauma and translated by changes in vital signs and consciousness ex Revised Trauma Score - Glasgow Coma Score - APACHE scoring Acute Physiology and Chronic Health Evaluation - APACHE I II III -Rapid Emergency Medicine Score REMS Combined scores include both anatomical and physiological criteria ex Trauma and Injury Severity Scores TRISS - A Severity Characterization of Trauma ASCOT-Kampala Trauma Score KTS
Trauma patients present to the emergency department ED with a great variety of injuries and diseases To address these the Abbreviated Injury Scale AIS system defines the severity of injury throughout the different regions of the body It is an anatomically based consensus derived global severity scoring system that classifies an individual injury by body region according to its relative severity on a 6-point scale 1 minor and 6 maximal The system is constantly revised expanded and improved and the Association for the Advancement of Automotive Medicine recently announced its latest revision the AIS 2005-Update 2008 and AIS 2015 To summarize a single patients multiple injures into a single score the Injury Severity Score ISS was created by Baker et al in 1974 which has been considered the gold standard among anatomic injury severity indicators It is based on the AIS severity values that is the summation of the squares of the severity digit in the AIS of the most severe injuries in three of six predefined body regions
However the ISS only includes one injury in each body region which leads to possible inclusion of a less severe injury in other body regions rather than another serious injury in the same body region To overcome this limitation a modified ISS the New Injury Severity Score NISS was introduced by Osler et al in 1997 NISS is simply the sum of squares of the three most severe injuries regardless of the body regions injured
Further Wang et al have created the Exponential Injury Severity Score EISS in 2014 by modifying the AIS system The EISS was computed as the simple change in AIS values by raising each AIS severity score 1-6 by 3 taking a power of AIS minus 2 and then summing the three most severe scores ie highest AIS values regardless of body regions With this exponential transformation of the AIS values the EISS is expected to be more reflective of the true severity of injuries in a patient with polytrauma In Wangs study the EISS is reported to be more predictive of survival therefore it might be used as the standard summary measure of human trauma
The aim of this study is to compare the ability of the new Exponential Injury Severity Score EISS with that of the Injury Severity Score ISS and the New Injury Severity Score NISS to identify patients at risk of in-hospital mortality or ICU admission and predict survival in Assiut University Hospitals
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None