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Validation of a Therapeutic Intervention Scoring System (TISS-28) in critically ill children

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Abstract Introduction There are numerous scales in intensive care units that are used to quantify the severity of patients. Most of them are very useful, although sometimes laborious to complete,… Click to show full abstract

Abstract Introduction There are numerous scales in intensive care units that are used to quantify the severity of patients. Most of them are very useful, although sometimes laborious to complete, thus limiting their use in usual practice. One of these scales, the Therapeutic Intervention Scoring System (TISS-76), has been validated in adult and paediatric units. Its simplified and updated version, the Simplified Therapeutic Intervention Scoring System (TISS-28), has not yet been validated in paediatric units. The aim of this study is to validate TISS-28, in order to have a simple and rapid scale. Material and method A prospective non-interventional observational study was conducted in a Paediatric Intensive Care Unit (PICU) of a university hospital. Data were collected from 935 consecutive patients admitted to the PICU over a 3-year period. These included the values of TISS-76 and TISS-28 during the first 4 days of admission and the subsequent outcome of the patients. Results The mean values of TISS-76 and TISS-28 for the first day of admission were 18.27 and 18.02, respectively. Values were higher in patients who had sequelae or died (17.58 versus 27.23 and 37.44, respectively for TISS-76 (p  A very good correlation was found between TISS-76 and TISS-28, with Pearson correlation and intraclass correlation coefficients >0.9 (except for the 2nd day). The correlation equation for the overall 4 days was: TISS-76 = −1.74 + 1.05 × TISS-28. TISS-28 was able to explain 82.4% of variability of TISS-76. The area under the curve with a confidence interval (CI) of 95% for the first day was 0.80 (0.73–0.87) for TISS-76, and 0.76 (0.67–0.84) for TISS-28. Conclusions On observing the results obtained, TISS-28 can replace TISS-76 in our PICU, without worsening the information provided. Being a reliable scale and easier to apply, its practical application could be useful.

Keywords: scoring system; system tiss; therapeutic intervention; tiss tiss; intervention scoring

Journal Title: Anales De Pediatria
Year Published: 2020

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