• J Wayne Meredith, Gregory Evans, Patrick D Kilgo, Ellen MacKenzie, Turner Osler, Gerald McGwin, Stephen Cohn, Thomas Esposito, Thomas Gennarelli, Michael Hawkins, Charles Lucas, Charles Mock, Michael Rotondo, Loring Rue, and Howard R Champion.
• Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. merediw@wfubmc.edu
• J Trauma. 2002 Oct 1;53(4):621-8; discussion 628-9.

ObjectiveThe purpose of this study was to compare the abilities of nine Abbreviated Injury Scale (AIS)- and (ICD-9)-based scoring algorithms in predicting mortality.MethodsThe scores collected on 76,871 incidents consist of four AIS-based algorithms (Injury Severity Score [ISS], New Injury Severity Score, Anatomic Profile Score [APS], and maximum AIS [maxAIS]), their four ICD to AIS mapped counterparts, and the ICD-9-based ISS (ICISS). A 10-fold cross-validation was performed and area under the receiver operating characteristic curve was used to determine algorithm discrimination. Hosmer-Lemeshow statistics were computed to gauge goodness-of-fit, and model refinement measured variance of predicted probabilities.ResultsOverall, the ICISS has the best discrimination and model refinement, whereas the APS has the best Hosmer-Lemeshow performance. ICD-9 to AIS mapped scores have worse discrimination than their AIS-based counterparts, but still show moderate performance.ConclusionDifferences in performance were relatively small. Complex scores such as the ICISS and the APS provide improvement in discrimination relative to the maxAIS and the ISS. Trauma registries should move to include the ICISS and the APS. The ISS and maxAIS perform moderately well and have bedside benefits.

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