基于国际疾病分类编码的综合创伤评分方法研究及其在颅脑外伤患者中的应用效果评价

目的 建立一种基于国际疾病分类（ICD）编码的简易综合创伤评分方法，并评价其在颅脑外伤患者中的应用效果。方法借鉴国外成熟评分方法思路构建评分模型。采用接收者工作特征（ROC）分析方法评价新评分方法预测355例颅脑外伤患者结局的效果，并与专家的改良损伤严重度评分（NISS）进行比较。结果新评分方法的ROC曲线下面积（AUC）为0．9254，95％可信区间0．8634-0．9875，与0．5比较P〈0．01；与两位专家的NISS评分之AUC比较P：0．4535，差异无统计学意义。结论基于ICD编码的综合创伤严重度评分（CISS）方法对创伤患者的结局具有较高的预测价值，且其操作成本低，可以作为一种理想的简易创伤评分方法。

A new comprehensive trauma score method based on international classification of diseases and the effectiveness of its use in cerebral injured patients

Objective To develop a new comprehensive trauma score method based on international classification of diseases(ICD) and evaluate the effectiveness of its use in cerebral injured patients.Methods The model of the new trauma score method was constructed by referring to those of some certain comprehensive trauma score methods generally used around the world.Receiver operating characteristics(ROC) analysis was employed to evaluate the effectiveness of outcome prediction for 355 cerebral injured patients using the new developed trauma score method.Statistical comparisons were performed between the AUC for the new trauma score values and that of NISS values derived from two professional raters.Results The area under the curve(AUC) for the new trauma score values was as large as 0.925 4,whose 95% CI ranged from 0.863 4 to 0.987 5,and is statistically different from 0.5(P<(0.01)).Statistical difference was not found between the AUC for the new trauma score value and that of NISS values of two raters(P=0.453 5).Conclusion The new developed trauma score method,namely CISS method,which is considerably effective in predicting the outcomes of trauma patients and more cost-effective,can be used as an alternative for those commonly used ones.