Limitations of the TRISS method for interhospital comparisons: a multihospital study

J Trauma. 1991 Apr;31(4):471-81; discussion 481-2. doi: 10.1097/00005373-199104000-00005.


The value of the TRISS method for interhospital comparisons of trauma care was studied using data for 5,616 consecutive patients from three trauma centers and five community hospitals. Z-scores were used to compare mortality rates. Three limitations of the method were documented: 1) the lack of homogeneity within the patient subcategory of penetrating injuries, specifically between patients with gunshot versus stab wounds; 2) the inability of the TRISS method to predict the survival rate of patients suffering low falls; and 3) the inability of the TRISS method to account for multiple severe injuries to a single body part. Remedies to the first two of these limitations can be addressed within the present TRISS method. A remedy for the third requires a new method.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abbreviated Injury Scale
  • Adult
  • Aged
  • Emergency Service, Hospital
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Multiple Trauma / mortality
  • Prognosis
  • Survival Rate
  • Trauma Severity Indices*
  • Wounds and Injuries / mortality*
  • Wounds, Nonpenetrating / mortality
  • Wounds, Penetrating / mortality