• Edward G Davis, Ellen J MacKenzie, William J Sacco, Lawrence W Bain, Robert F Buckman, Howard R Champion, and Peter S J Lees.
• Bloomberg School of Public Health, Department of Environmental Health Sciences, Johns Hopkins University, Baltimore, MD, USA.
• J Trauma. 2003 Jul 1;55(1):53-61.

BackgroundPrehospital trauma patient field intubations and paralyzations, using neuromuscular blocking agents before emergency department respiratory and neurologic assessments are made, bias assessments and outcome evaluations using probability-of-survival models, such as TRISS and A Severity Characterization of Trauma (ASCOT). We present a newly developed "TRISS-like" probability-of-survival model for intubated blunt- and penetrating-injured patient assessment.MethodsFrom a population of 51397 consecutively admitted trauma patients, this study used all 5740 (11.2% of the total injured population) intubated patients with complete data from a statewide trauma registry from October 1, 1993, to September 30, 1996. Model performance was evaluated using standard calibration and discrimination measures and z and W statistics of significance.ResultsThe new model accurately predicted survival for blunt- and penetrating-injured intubated patients and is applicable to 11 etiologic patient populations.ConclusionStudy findings suggest that the new TRISS-like model should be used to assess both blunt- and penetrating-injured intubated patients. Use of this new model provides an analytical method for addressing a significant limitation of both the standard TRISS and ASCOT models, which are not applicable to intubated injured patient assessment. In addition, use of this model will complement TRISS/ASCOT assessments of nonintubated trauma patients and thus permit appropriate assessments for both intubated and nonintubated injured patient study populations.

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