PMID- 23219241
OWN - NLM
STAT- MEDLINE
DCOM- 20150804
LR  - 20220330
IS  - 1879-0267 (Electronic)
IS  - 0020-1383 (Linking)
VI  - 45
IP  - 1
DP  - 2014 Jan
TI  - Physiologic, demographic and mechanistic factors predicting New Injury Severity 
      Score (NISS) in motor vehicle accident victims.
PG  - 9-15
LID - S0020-1383(12)00496-2 [pii]
LID - 10.1016/j.injury.2012.11.010 [doi]
AB  - BACKGROUND: Current literature on motor vehicle accidents (MVAs) has few reports 
      regarding field factors that predict the degree of injury. Also, studies of 
      mechanistic factors rarely consider concurrent predictive effects of on-scene 
      patient physiology. The New Injury Severity Score (NISS) has previously been 
      found to correlate with mortality, need for ICU admission, length of hospital 
      stay, and functional recovery after trauma. To potentially increase future 
      precision of trauma triage, we assessed how the NISS is associated with 
      physiologic, demographic and mechanistic variables from the accident site. 
      METHODS: Using mixed-model linear regression analyses, we explored the 
      association between NISS and pre-hospital Glasgow Coma Scale (GCS) score, Revised 
      Trauma Score (RTS) categories of respiratory rate (RR) and systolic blood 
      pressure (SBP), gender, age, subject position in the vehicle, seatbelt use, 
      airbag deployment, and the estimated squared change in vehicle velocity on impact 
      ((Deltav)(2)). Missing values were handled with multiple imputation. RESULTS: We 
      included 190 accidents with 353 dead or injured subjects (mean NISS 17, median 
      NISS 8, IQR 1-27). For the 307 subjects in front-impact MVAs, the mean increase 
      in NISS was -2.58 per GCS point, -2.52 per RR category level, -2.77 per SBP 
      category level, -1.08 for male gender, 0.18 per year of age, 4.98 for driver vs. 
      rear passengers, 4.83 for no seatbelt use, 13.52 for indeterminable seatbelt use, 
      5.07 for no airbag deployment, and 0.0003 per (km/h)(2) velocity change (all 
      p<0.002). CONCLUSION: This study in victims of MVAs demonstrated that injury 
      severity (NISS) was concurrently and independently predicted by poor pre-hospital 
      physiologic status, increasing age and female gender, and several mechanistic 
      measures of localised and generalised trauma energy. Our findings underscore the 
      need for precise information from the site of trauma, to reduce undertriage, 
      target diagnostic efforts, and anticipate need for high-level care and 
      rehabilitative resources.
CI  - Copyright (c) 2012 Elsevier Ltd. All rights reserved.
FAU - Staff, T
AU  - Staff T
AD  - Department of Research, Norwegian Air Ambulance Foundation, Holterveien 24, PO 
      Box 94, 1441 Drobak, Norway; Norwegian National Centre for Prehospital Emergency 
      Medicine, Division of Emergencies and Critical Care, Oslo University Hospital, PO 
      Box 4956 Nydalen, 0424 Oslo, Norway. Electronic address: 
      trine.staff@medisin.uio.no.
FAU - Eken, T
AU  - Eken T
FAU - Wik, L
AU  - Wik L
FAU - Roislien, J
AU  - Roislien J
FAU - Sovik, S
AU  - Sovik S
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20121204
PL  - Netherlands
TA  - Injury
JT  - Injury
JID - 0226040
SB  - IM
MH  - Accidents, Traffic/*mortality
MH  - Blood Pressure Determination
MH  - Cause of Death
MH  - Critical Care/*statistics & numerical data
MH  - Cross-Sectional Studies
MH  - *Emergency Service, Hospital
MH  - Female
MH  - Glasgow Coma Scale
MH  - Humans
MH  - Injury Severity Score
MH  - Length of Stay/*statistics & numerical data
MH  - Linear Models
MH  - Male
MH  - Motor Vehicles
MH  - Norway
MH  - Predictive Value of Tests
MH  - Recovery of Function
MH  - Respiratory Rate
MH  - Seat Belts/statistics & numerical data
MH  - Survival Rate
MH  - *Triage
MH  - Wounds and Injuries/*mortality
OTO - NOTNLM
OT  - Abbreviated Injury Scale
OT  - Airbags
OT  - Glasgow Coma Scale, Blood pressure, Respiratory rate
OT  - Prehospital emergency care
OT  - Revised Trauma Score
OT  - Seatbelt
OT  - Traffic accident
OT  - Triage
EDAT- 2012/12/12 06:00
MHDA- 2015/08/05 06:00
CRDT- 2012/12/11 06:00
PHST- 2012/07/01 00:00 [received]
PHST- 2012/10/16 00:00 [revised]
PHST- 2012/11/11 00:00 [accepted]
PHST- 2012/12/11 06:00 [entrez]
PHST- 2012/12/12 06:00 [pubmed]
PHST- 2015/08/05 06:00 [medline]
AID - S0020-1383(12)00496-2 [pii]
AID - 10.1016/j.injury.2012.11.010 [doi]
PST - ppublish
SO  - Injury. 2014 Jan;45(1):9-15. doi: 10.1016/j.injury.2012.11.010. Epub 2012 Dec 4.