• Philip J Schluter, Cate M Cameron, Tamzyn M Davey, Ian Civil, Jodie Orchard, Rangi Dansey, James Hamill, Helen Naylor, Carolyn James, Jenny Dorrian, Grant Christey, Cliff Pollard, and Rod J McClure.
• School of Public Health and Psychosocial Studies, AUT University, Auckland, New Zealand. philip.schluter@aut.ac.nz
• N. Z. Med. J. 2009 Sep 11;122(1302):54-64.

AimsTo develop local contemporary coefficients for the Trauma Injury Severity Score in New Zealand, TRISS(NZ), and to evaluate their performance at predicting survival against the original TRISS coefficients.MethodsRetrospective cohort study of adults who sustained a serious traumatic injury, and who survived until presentation at Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Coefficients were estimated using ordinary and multilevel mixed-effects logistic regression models.Results1735 eligible patients were identified, 1672 (96%) injured from a blunt mechanism and 63 (4%) from a penetrating mechanism. For blunt mechanism trauma, 1250 (75%) were male and average age was 38 years (range: 15-94 years). TRISS information was available for 1565 patients of whom 204 (13%) died. Area under the Receiver Operating Characteristic (ROC) curves was 0.901 (95%CI: 0.879-0.923) for the TRISS(NZ) model and 0.890 (95% CI: 0.866-0.913) for TRISS (P<0.001). Insufficient data were available to determine coefficients for penetrating mechanism TRISS(NZ) models.ConclusionsBoth TRISS models accurately predicted survival for blunt mechanism trauma. However, TRISS(NZ) coefficients were statistically superior to TRISS coefficients. A strong case exists for replacing TRISS coefficients in the New Zealand benchmarking software with these updated TRISS(NZ) estimates.

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