Evaluation of Probability of Survival using APACHE II & TRISS Method in Orthopaedic Polytrauma Patients in a Tertiary Care Centre RC01-RC04
Dr. Atul Agrawal,
Associate Professor, Department of Orthopaedics, Himalayan Medical Institute, Jollygrant, Dehradun, India.
E-mail : firstname.lastname@example.org
Aim: The aim of the study was to assess the ability of Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and Trauma and Injury Severity Score (TRISS) method to evaluate chances of survival of orthopaedic polytrauma patients.
Materials and Methods: It is a retrospective study carried out at a tertiary care teaching hospital situated in a hilly terrain. The medical records of 535 polytrauma patients admitted to ICU from January 2012 to April 2015 were examined of which only 95 were included into the study. The APACHE II scores were calculated from data at the time of admission, on day 1 after admission and on day 5. Data from casualty department was used to calculate TRISS. For each patient APACHE II and TRISS was used to calculate their probability of death. Receiver operating characteristic curve analysis was used to assess the ability of APACHE II and TRISS to predict mortality.
Results: In the receiver operating characteristic curve analysis, the areas under the curve for TRISS, APACHE II on admission and APACHE II on day one of admission scoring system was 0.831, 0.706, 0.885 respectively. Sensitivity and specificity for TRISS was 83.64 and 77.50 respectively while for APACHE II score on day one of admission was 90.91 and 72.50.
Conclusion: The results from the present study showed that APACHE II score on day one of admission was relatively a better predictor than TRISS score and a far better predictor than APACHE II on admission in evaluating probability of survival of a patient.