Accuracy of the Trauma and Injury Severity Score (TRISS) in the Predicting Mortality of Emergency Patients: Focus on Evaluation at Three Critical Time Intervals.

Fenny Tianda; Syahrun Syahrun; Kumboyono Kumboyono; Suryanto Suryanto

doi:10.30872/j.kes.pasmi.kal.v8i1.21108

Accuracy of the Trauma and Injury Severity Score (TRISS) in the Predicting Mortality of Emergency Patients: Focus on Evaluation at Three Critical Time Intervals.

Fenny Tianda, Syahrun Syahrun, Kumboyono Kumboyono, Suryanto Suryanto

Abstract

Latar Belakang: Trauma merupakan penyebab utama morbiditas dan mortalitas global, termasuk di Indonesia. Sistem skoring trauma seperti Trauma and Injury Severity Score (TRISS) dan Injury Severity Score (ISS) digunakan untuk memprediksi mortalitas pasien trauma, namun efektivitasnya perlu dievaluasi di berbagai rentang waktu kritis.Tujuan: Menilai akurasi TRISS dalam memprediksi mortalitas pasien trauma di Instalasi Gawat Darurat (IGD) pada jam ke-6, 24, dan 48 setelah kejadian trauma, dengan ISS sebagai gold standard. Metode: Penelitian uji diagnostik cross-sectional dilakukan di RSUD IA Moeis Samarinda (Januari–Maret 2024) dengan sampel 166 pasien trauma (kriteria inklusi: usia >16 tahun, data lengkap; eksklusi: Death On Arrival, penyakit penyerta). Data dianalisis menggunakan uji Spearman’s rho, kurva ROC, serta par TRISS menunjukkan sensitivitas sangat tinggi (98,9%) di semua rentang waktu, dengan nilai AUC optimal (0,973–0,994), mengindikasikan kemampuan prediktif yang sangat baik. Spesifisitas TRISS meningkat dari 77,1% (jam ke-6) menjadi 85,7% (jam ke-48). Akurasi TRISS juga tinggi (89,7–93,3%), melebihi ISS (87,5%). Korelasi signifikan ditemukan antara skor trauma dengan mortalitas (p <0,001).ameter sensitivitas, spesifisitas, Positive Predictive Value (PPV), Negative Predictive Value (NPV), dan akurasi. Hasil: TRISS menunjukkan sensitivitas sangat tinggi (98,9%) di semua rentang waktu, dengan nilai AUC optimal (0,973–0,994), mengindikasikan kemampuan prediktif yang sangat baik. Spesifisitas TRISS meningkat dari 77,1% (jam ke-6) menjadi 85,7% (jam ke-48). Akurasi TRISS juga tinggi (89,7–93,3%), melebihi ISS (87,5%). Korelasi signifikan ditemukan antara skor trauma dengan mortalitas (p <0,001). Kesimpulan: TRISS unggul dalam memprediksi mortalitas pasien trauma di IGD, terutama pada evaluasi jam ke-48, dengan sensitivitas dan akurasi yang stabil. Rekomendasikan penggunaan TRISS untuk triase awal dan manajemen pasien trauma di fasilitas kesehatan dengan sumber daya terbatas.
Kata kunci: TRISS, ISS, mortalitas, trauma, prediksi, IGD

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DOI: http://dx.doi.org/10.30872/j.kes.pasmi.kal.v8i1.21108

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