The military injury severity score (mISS): A better predictor of combat-mortality than injury severity score (ISS).

BACKGROUND: The military Injury Severity Score (mISS) was developed to better predict mortality in complex combat injuries, but has yet to be validated. METHODS: U.S. combat trauma data from Afghanistan and Iraq from January 1, 2003 to December 31, 2014 from the DoD Trauma Registry (DoDTR) were analyzed. mISS, a variation of the ISS, was calculated and compared to standard ISS scores. Receiver Operator Characteristics (ROC), area under the curve (AUC) and Hosmer-Lemeshow statistics were used to discriminate and calibrate between mISS and ISS. Wilcoxon-Mann-Whitney, t-test and Chi-square tests were used and sensitivity and specificity calculated. Logistic regression was used to calculate the likelihood of mortality associated with levels of mISS and ISS overall. RESULTS: 30,364 patients were analyzed. Most were male (96.8%). Median (IQR) age was 24 (21-29). Battle injuries comprised 65.3%. Penetrating (39.5%) and blunt (54.2%) injury types, and explosion (51%) and gunshot wound (15%) mechanisms predominated. Overall mortality was 6.0%. Median mISS and ISS were similar in survivors (5[2-10] vs. 5 [2-10]) but different in non-survivors, 30 (16-75) vs. 24 (9-23), respectively (P

from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/1nyrHj3