Diagnostic accuracy of TRISS, GAP score, and KTS in predicting survival of traumatic brain injury patients

Akhmad Fauzi; Kuswantoro Rusca Putra; Rinik Eko Kapti

doi:10.21927/jnki.2025.13(4).539-557

Diagnostic accuracy of TRISS, GAP score, and KTS in predicting survival of traumatic brain injury patients

Akhmad Fauzi, Kuswantoro Rusca Putra, Rinik Eko Kapti

Abstract

Background: Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality worldwide, often resulting in long-term disability or death. The critical period for survival is within the first 6–12 hours after trauma, when secondary brain injury may occur due to hypoxia, hypotension, and systemic complications. To assist clinicians in predicting patient outcomes, several trauma scoring systems have been developed, including the Trauma and Injury Severity Score (TRISS), Glasgow Coma Scale–Age–Systolic Pressure (GAP) Score, and Kampala Trauma Score (KTS).

Objectives: This study aims to evaluate the accuracy of these three scoring systems in predicting survival outcomes in TBI patients

Methods: This research employed a quantitative observational analytic design with a cohort approach involving 212 patients who presented to the Emergency Department (ED) with TBI. Patients were assessed using TRISS, GAP Score, and KTS, and survival status was observed for up to 6 hours. Data were collected by trained ED nurses using standardized procedures, including measurement of Glasgow Coma Scale (GCS), age, respiratory rate, neurological status, systolic blood pressure, and the number of severe injuries. Data analysis included diagnostic tests such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.

Results: The results indicate that GAP Score had the highest sensitivity (99,5%), while GAP score demonstrated the highest specificity (85,7%). The highest PPV was found in TRISS and GAP score (97,1%), whereas KTS had the highest NPV (71,4%). GAP Score achieved the highest accuracy (96,7%), making it the most effective method for predicting TBI patient survival.

Conclusions: The GAP Score is recommended as the most accurate and practical tool for predicting survival in traumatic brain injury patients presenting to the emergency department, especially in clinical environments that require rapid decision-making.

Keywords

GAP score; KTS; survival; traumatic brain injury; TRISS

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DOI: http://dx.doi.org/10.21927/jnki.2025.13(4).539-557