Comparison of the efficacy of trauma scores in predicting prognosis and hospitalization

Year 2021, Volume: 46 Issue: 4, 1596 - 1605, 30.12.2021

Hatice Şeyma Akça , Abdullah Algın , Serdar Özdemir , Elif Koçkara , Serkan Emre Eroğlu

https://doi.org/10.17826/cumj.982675

Cited By: 3

Abstract

Purpose: The aim of this study was to compare the efficacy of ISS (injury Severity Score), RTS (Revised Trauma Score) and ViEWS (VitalPAC Early Warning Score) scoring systems in predicting prognosis and mortality.
Materials and Methods: Patients over the age of 18 who presented with multitrauma were prospectively examined between May 1, 2019 and November 1, 2019. Trauma scores, clinical outcomes within the first 24 hours, surgery requirement and 30-day mortality data were recorded.
Results: The study included 435 patients, of whom 333 (76.6%) were male. The median age was 34 (IQR: 18-90) years. It was observed that ISS, RTS and ViEWS had a significant relationship with 30-day mortality. In the ROC analysis of 30-day mortality, no statistically significant difference was observed between the ISS, RTS, and ViEWS AUC values. There was also no statistically significant difference in terms of the ISS, RTS and ViEWS according to the length of hospital stay and surgery requirement.
Conclusion: In addition to their relationship with mortality, it should be kept in mind that the investigated scoring systems may also be related to the length of hospital stay and surgery requirement.

Keywords

ISS, RTS, VİEWS, trauma, trauma scores

Travma skorlarının prognozu ve hastaneye yatışı öngörmede etkinliğinin karşılaştırılması

Abstract

Amaç: Bu çalışmada travma skorlama sistemlerinden ISS (Injury Severity Score), RTS (Revised Trauma Score) ve VİEWS (VitalPAC Early Warning Score)’in prognoza ve mortaliteye etkilerinin karşılaştırılması amaçlanmıştır.
Gereç ve Yöntem: Multitravma ile gelen 18 yaş üstü onam alınan hastalar 01.05.2019-01.11.2019 tarihleri arasında prospektif olarak incelendi. Travma skorları, ilk 24 saatlik klinik sonlanım, cerrahi gerekliliği ve 30 günlük mortalite verileri kaydedildi.
Bulgular: Çalışmaya 435 hasta dahil edildi. Hastaların 333’ü (%76,6) erkek idi. Yaş median değeri 34(IQR:18-90) idi. 30 günlük mortalite oranı, ilk 24 saatte hospitalizasyon oranı, ICU yatış oranı ve cerrahi gereklilik oranı sırasıyla; %1,1, %19,1, %1,8 ve %8,5 idi. ISS, RTS ve VİEWS’in 30 günlük mortalite ile anlamlı ilişkisi olduğu gözlendi. 30 günlük mortalite ile ilgili olarak yapılan ROC analizinde ISS, RTS, and VIEWS AUC değerleri arasında istatistiksel olarak anlamlı fark bulunmamıştır. Hastanede yatış süresi ve operasyon gerekliliği açısından da ISS, RTS ve VİEWS arasında istatistiksel olarak anlamlı fark bulunmamıştır.
Sonuç: Travma skorlama sistemlerinin mortalite ile ilişkisinin karşılaştırılmasının yanısıra, hastanede kalış süresi ve operasyon ihtiyacı olup olmaması ile bu skorlama sistemlerinin ilişkili olabileceği unutulmamalıdır.

Keywords

ISS, RTS, VİEWS, travma skorları, travma, mortalite

References

• 1)Hietbrink F, Koenderman L, Rijkers GT, Leenen LPH. Trauma: the role of the innate immune system. World J Emerg Surg. 2006;20(1):15. Doi:10.1186/1749-7922-1-15.
• 2)Keel M, Trentz O. Pathophysiology of polytrauma. Injury. 2005;36(6):691-709. Doi:10.1016/j.injury.2004.12.037.
• 3) Mariani A, Casella G, Aseni P. From Trauma Scoring System to Early Appropriate Care. Operative Techniques and Recent Advances in Acute Care and Emergency Surgery. 2019:129-40. https://doi.org/10.1007/978-3-319-95114-0_9.
• 4)Gofrit ON, Leibovici D, Shapiro SC, Shemer J, Stein M, Michaelson M. The trimodal death distribution of trauma victims: military experience from the LebanonWar. Mil Med. 1997;162(1):24-6. https://doi.org/10.1093/milmed/162.1.24.
• 5)Bouzat P, Broux C, Ageron FX, F Thony, C Arvieux, J Tonetti et al. Trauma network for severely injured patients. Ann FrAnesth Reanim. 2013;32(7-8):531-4. Doi: 10.1016/j.annfar.2013.07.014.
• 6)Joosse P, Soedarmo S, Luitse JS, Ponsen KJ. Trauma outcome analysis of a Jakarta University Hospital using the TRISS method: validation and limitation in comparison with the major trauma outcome study. Trauma and Injury Severity Score. J Trauma. 2001;51(1):134-40. Doi:10.1097/00005373-200107000-00021.
• 7)Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187-96.
• 8)Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flanagan ME. A revision of the trauma score. J Trauma. 1989;29(5):623-9. Doi:10.1097/00005373-198905000-00017.
• 9) Shi j, Shen J, Zhu M, Wheeler KK, Lu B, Kenney B et al. A new weighted injury severity scoring system: beter predictive power for adult trauma mortality. Injury Epidemiology. 2019; 6:40. https://doi.org/10.1186/s40621-019-0217-8.
• 10)Haider AA, Azim A, Rhee PM, Kulvatunyou N, Ibraheem K, Tang A et al. Substituting systolic blood pressure with shock index in the National Trauma Triage Protocol. J Trauma Acute Care Surg. 2016;81(6):1136-41. https://doi.org/10.1097/TA.0000000000001205.
• 11)Subbe CP, Kruger M, Rutherford P, Gemmel L. Validation of a modified early warning score in medical admissions. QJMed. 2001;94(10):521-526. Doi:10.1093/qjmed/94.10.521.
• 12)Prytherch DR, Smith GB, Schmidt PE, Featherstone PI. ViEWS – Towards a national early warning score for detecting adult inpatient deterioration. Resuscitation. 2010;81(8):932-937. Doi: 10.1016/j.resuscitation.2010.04.014.
• 13) Galvagno SM, Massey M, Bouzat P, Vesselinov R, Levy MJ, Millin MG et al. Correlation Between the Revised Trauma Score and Injury Severity Score: Implications for Prehospital Trauma Triage. Prehospital Emergency Care. 2018, Doi: 10.1080/10903127.2018.1489019.
• 14)Husum H, Strada G. Injury severity score versus new injury severity score for penetrating injuries. PrehospDisast Med. 2002;17(1):27-32. Doi:10.1017/s1049023x0000008x.
• 15)Stevenson M, Segui0-Gomez M, Lescohler I, Di Scala C, McDonald-Smith G. An overview of the injury severity score and the new injury severity score. Inj Prev. 2001;7(1):10-3. Doi:10.1136/ip.7.1.10.
• 16)Norouzi V, Feizi I, Vatankhah S, Pourshaikhian M. Calculation of the probability of survival for trauma patients based on trauma score and the injury severity score model in Fatemi hospital in Ardabil. Arch Trauma Res. 2013;2(1):30-5. Doi: 10.5812/atr.9411.
• 17)Bouzat P, Legrand R, Gillois P, Ageron FX, Brun J, Savary D et al. TRENAU Group. Prediction of intra-hospital mortality after severe trauma: which pre-hospital score is the most accurate? Injury Int J Care Injured. 2016;47(1):14-8. Doi: 10.1016/j.injury.2015.10.035.
• 18)Javali RH, Krishnamoorthy, Patil A, Srinivasarangan M, Suraj, Sriharsha. Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients. Indian J Crit Care Med. 2019;23(2):73-77. Doi: 10.5005/jp-journals-10071-23120.
• 19)Ünlü AR, Ülger F, Dilek A, Barış S, Murat N, Sarıhasan B. Evaluation of the Relationship Between Revised Trauma Score, and Trauma and Injury Severity Scores with Prognosis of Trauma Patients in Intensive Care Unit. J Turk Anaesth Int Care. 2012;40(3):128-35. Doi:10.5222/JTAICS.2012.128.
• 20)Aydın ŞA, Bulut M, Fedakar R, Özgürer A, Özdemir F. Trauma in the elderly patients in Bursa. Turkish Journal of trauma and Emergency Surgery. 2006;12(3):230-4.
• 21)Yousefzadeh-Chabok S, Hosseinpour M, Kouchakinejad-Eramsadati L, Ranjbar F, Malekpouri R, Razzaghi A et al. Comparison of revised trauma score, injury severity score and trauma and injury severity score for mortality prediction in elderly trauma patients, Turkish journal of Trauma and Emergency Surgery. 2016;22(6):536-40. Doi: 10.5505/tjtes.2016.93288.
• 22) Çetinkaya HB, Köksal Ö, Sigirli D, Leylek EH, Karasu Ö. The predictive value of the modified early warning score with rapid lactate level (ViEWS-L) for mortality in patients of age 65 or older visiting the emergency department. Intern Emerg Med.2017;12: 1253–1257. Doi: 10.1007/s11739-016-1559-7.
• 23)Jiang L, Zheng Z, Zhang M. The incidence of geriatric trauma is increasing and comparison of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients. World J Emerg Surg. 2020;15:59. Doi:10.1186/s13017-020-00340-1.
• 24)Adıyaman E, Tokur ME, Bal ZM, Gökmen AN, Koca U. Retrospective Analysis of Trauma Patients Who were Treated and Followed in Anesthesia Intensive Care Unit. Turk J Intensive Care 2019;17:146-53. Doi: 10.4274/tybd.galenos.2018.82905.
• 25) Jo S, Lee JB, Jin YH, Jeong T, Yoon J, Choi SJ et al. Comparison of the trauma and injury severity score and modified early warning score with rapid lactate level (the ViEWS-L score) in blunt trauma patients. Eur J Emerg Med. 2014;21(3):199-205. Doi: 10.1097/MEJ.0b013e32836192d6.
• 26) Kara İ, Altınsoy S, Gök U, Onur A, Sarıbabıççı R. Mortality Analysis of trauma patients in General Intensive Care Unit of a state hospital. Turk J Intense Care. 2015;13(2):68- 74. Doi: 10.4274/tybdd.54154.
• 27)Yazar MA, Sarıkuş Z, Horasanlı E. Thirty-day Mortality Outcomes of Trauma Patients in the Intensive Care Unit: A Three-year Retrospective Study. Turk J Intensive Care. 2019;17(1):18-24. Doi: 10.4274/tybd.galenos.2018.75437.