• Kei Ching Kevin Hung, Chun Yu Lai, Janice Hiu Hung Yeung, Marc Maegele, Po Shan Lily Chan, Ming Leung, Hay Tai Wong, John Kit Shing Wong, Ling Yan Leung, Marc Chong, Chi Hung Cheng, Nai Kwong Cheung, and Colin Alexander Graham.
• Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Shatin, Hong Kong.
• Eur J Trauma Emerg Surg. 2022 Apr 1; 48 (2): 1093-1100.

PurposeHong Kong (HK) trauma registries have been using the Trauma and Injury Severity Score (TRISS) for audit and benchmarking since their introduction in 2000. We compare the mortality prediction model using TRISS and Revised Injury Severity Classification, version II (RISC II) for trauma centre patients in HK.MethodsThis was a retrospective cohort study with all five trauma centres in HK. Adult trauma patients with Injury Severity Score (ISS) > 15 suffering from blunt injuries from January 2013 to December 2015 were included. TRISS models using the US and local coefficients were compared with the RISC II model. The primary outcome was 30-day mortality and the area under the receiver operating characteristic curve (AUC) for tested models.Results1840 patients were included, of whom 1236/1840 (67%) were male. Median age was 59 years and median ISS was 25. Low falls were the most common mechanism of injury. The 30-day mortality was 23%. RISC II yielded a superior AUC of 0.896, compared with the TRISS models (MTOS: 0.848; PATOS: 0.839; HK: 0.858). Prespecified subgroup analyses showed that all the models performed worse for age ≥ 70, ASA ≥ III, and low falls. RISC II had a higher AUC compared with the TRISS models in all subgroups, although not statistically significant.ConclusionRISC II was superior to TRISS in predicting the 30-day mortality for Hong Kong adult blunt major trauma patients. RISC II may be useful when performing future audit or benchmarking exercises for trauma in Hong Kong.© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.

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