The new Injury Severity Score: a more accurate predictor of need ventilator and time ventilated in trauma patients than the Injury Severity Score

Ulus Travma Acil Cerrahi Derg. 2008 Apr;14(2):110-7.


Background: This study validates the accuracy of the Injury Severity Score (ISS) and the New Injury Severity Score (NISS) systems for prediction of need intubatin (NI), need mechanical ventilation (NMV), and duration of mechanical ventilation (DMV) in intensive care unit (ICU) trauma patient admissions.

Methods: One-hundred ten trauma patients were included in this prospective cohort study. The predictive accuracies of the ISS and the NISS were compared using Receiver Operator Characteristic (ROC) curves and Hosmer-Lemeshow (H-L) statistics for the logistic regression model of ICU admission.

Results: For prediction of NI, the best cut-off points were 22 for ISS and 27 for NISS. The positive prediction value was 91.6% in NISS and 87.8% in ISS. The Youden index had best cut-off points at 0.47 for NISS and 0.57 for ISS. The area under Receiver Operating Characteristic (ROC) curve was 0.79 in the ISS and 0.86 in the ISS. There were statistical differences among NISS with ISS in terms of Youden index and the area under the ROC curve (p<0.05). For the prediction of NMV, NISS yielded significantly better results in the area under the ROC curve and Youden index than those of ISS (p<0.05).

Conclusion: For prediction of NI or NMV, the NISS has better accuracy than ISS.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Critical Care
  • Female
  • Humans
  • Injury Severity Score*
  • Male
  • Middle Aged
  • Multiple Trauma / physiopathology*
  • Multiple Trauma / therapy*
  • Predictive Value of Tests
  • Prospective Studies
  • Reproducibility of Results
  • Respiration, Artificial*
  • Sensitivity and Specificity