Podium (General) 07

The Inter-rater and Intra-rater Reliability of Ganga Hospital Open Injury Severity Scoring (GHOIS) for the Assessment of High Energy Limb Trauma in the Tertiary Military Hospital

Brian Kenneth K Dela Cruz, MD
Antonio Manuel T Saludo, MD, FPOA

Background: Major advances have been achieved in the last couple of decades in the management of open injuries of limbs, which has helped to achieve restoration of function of patients. However these injuries continue to remain as a major challenge in management with a high potential for loss of limb or life and a poor functional outcome even after adequate treatment. Numerous scoring system have been proposed to provide guidelines but has limitations and disadvantages in assessing limb injuries and have a poor sensitivity and specificity in evaluating IIIB injuries. In 2004, the Ganga Hospital Open Injury Severity Score (GHOIS) was proposed and is specifically designed to address the outcome in IIIB injuries of the tibia and offers guidelines in the choice of the appropriate reconstruction protocol.


Objectives: To determine the reliability of the GHOIS in predicting limb salvage among high energy trauma cases at the AFPHSC


Design: Cross sectional study


Setting: Tertiary Military Hospital

Participants: 15 patient`s hospital record diagnosed with Open Gustillo Type III fractures and 23 orthopedic resident were identified and agreed to participate in the study


Methodology: 15 cases will be interpreted by 23 orthopedic residents using the GHOIS scoring and the same set of cases will be administered one month apart to the same group of people. An SPSS version 26 will be used for the analysis of the relevant statistics. For the analysis of inter-rater reliability, Fleiss’ multirater kappa will be used. A value of greater than 0.70 is a satisfactory measure of interrater reliability. For the analysis of intra-rater reliability, a One-way Analysis of Variance (ANOVA) will be employed. Any ANOVA p-values lesser than 0.05 will be considered statistically significant differences in the scores.


Results: The study was able to obtain data from 15 patient`s hospital record and 23 orthopedic residents.