The Value Of AIS-ISS Score In Prognosis Evaluation Of Multiple Injury Patients With Head Injury

Objective:To investigate the prognostic value of abbreviated injury score(AIS)and injury severity score(ISS)in multiple injury patients with head injury.Methods:A retrospective analysis of 354 patients admitted to the emergency department and intensive care unit during November 2010 to October 2017 was performed,and the Glasgow outcome scale(GOS)was followed-up 6 months after the injury.The patients were divided into two groups according to the GOS:good outcome group(4 to 5)and poor outcome group(1 to 3).Relevant clinical parameters were studied by statistical description,logistic regression analysis,spearman correlation analysis and ROC curve analysis.Results:ISS level was continuously increased with the decrease of GOS from score 5 to 1.Univariate logistic regression analysis suggested that age,GCS,pupil reactivity and ISS level(OR 1.205,95%CI:1.161～1.251)were relevant with poor outcome(P<0.01).The ISS level and the other independent prognostic predictors as age,GCS and pupil reactivity were further included in the multivariate logistic regression model,and the adjusted OR of ISS level was 1.096(95%CI:1.030～1.166,P<0.01).ROC curve analysis showed the AUC for ISS was 0.853(95%CI:0.808～0.897).Spearman analysis with grouped GCS(GCS≤5、GCS>5)suggested that in high GCS group(r=-0.356,P<0.05)ISS has a greater relation with GOS compared with low GCS group(r=-0.247,P<0.05).The AIS components of ISS were also analyzed,multivariate logistic regression suggested that the head AIS and chest AIS were correlated with poor outcome(OR of head AIS 1.708,95%CI:1.154～2.526,P<0.05;OR of chest AIS 1.609,95%CI:1.073～2.412,P<0.05).The relevant analysis revealed a significant negative correlation between ISS and GOS(r=-0.603,P<0.01).The Mann-whitney U test was used to analyze the relationship between ISS score and AIS components and prognosis.It was found that when the GCS score was>12,ISS score was significantly different between the good group and the bad group.(Z=-7.967,P<0.05).Conclusion:AIS-ISS score is an independent predictor of poor prognosis in patients with multiple injuries associated with traumatic brain injury.In the GCS<5 group,due to the severity of traumatic brain injury,the prognostic evaluation value of AIS-ISS score was relatively low,suggesting that intracranial injury more affected the prognosis.In patients with multiple injuries complicated with mild Traumatic brain injury with high GCS score,AIS-ISS score is more powerful in evaluating the prognostic ability,suggesting that extracranial injury has a greater impact on the prognosis of patients.