Trauma outcome analysis of a Jakarta University Hospital using the TRISS method: validation and limitation in comparison with the major trauma outcome study. Trauma and Injury Severity Score

J Trauma. 2001 Jul;51(1):134-40. doi: 10.1097/00005373-200107000-00021.


Background: In this prospective study, the TRISS methodology is used to compare trauma care at a University Hospital in Jakarta, Indonesia, with the standards reported in the Major Trauma Outcome Study (MTOS).

Methods: Between February 24, 1999, and July 1, 1999, all consecutive patients with multiple and severe trauma were included in the study (n = 105). Survival analysis was completed for 97 (92%) patients.

Results: The majority of patients were men (81%), and the average age was 28 years. Ninety-five patients (98%) sustained blunt trauma, with motor vehicle crashes being the most common (68%). The predicted mortality was 14% and the observed mortality was 29%. The Z and M statistics were 7.87 and 0.843, respectively.

Conclusion: We conclude that in developing countries both institution-bound factors and specific limitations in the TRISS methodology are responsible for the difference between predicted and observed mortality, indicating the need for a regional database.

MeSH terms

  • Adolescent
  • Adult
  • Artificial Intelligence*
  • Bias
  • Developing Countries*
  • Expert Systems*
  • Female
  • Humans
  • Indonesia / epidemiology
  • Male
  • Mathematical Computing*
  • Multiple Trauma / mortality*
  • Multiple Trauma / therapy
  • Neural Networks, Computer*
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Sensitivity and Specificity
  • Survival Analysis
  • Trauma Centers / statistics & numerical data