Assessment of the Usefulness of Various Trauma Scoring Systems on the Prognosis of Multiple-Injury Patients

Kim, Kyung Hwan; Kim, Hong Yong

Abstract

In developed countries, several trauma scoring systems are used for victims. But we do not have an optimal method in Korea for evaluating our trauma patients effectively. The purpose of this study is to assess the usefulness of various trauma scoring systems based on the physiologic and anatomic state of the patient and based on time-related variables applicable to the trauma patients and to find a practical method to evaluate the patient's health status and to predict a prognosis. A prospective analysis of 135 consecutive multiple trauma patients admitted to the intensive care unit (ICU) through the emergency center between August 1995 and March 1996 was performed with respect to various trauma scoring systems and time-related and physiological variables (e.g., Glasgow Coma Scale (GCS), Trauma Score (TS), triage-Revised Trauma Score (t-RTS), Revised Trauma Score (RTS), Injury Severity Score (ISS), Probability of Survival by Trauma Score (Revised) Injury Severity Score (TRISS), hospital stay, ICU stay, prehospital time, systolic blood pressure (SBP), and respiration rate (RR)). The range of age was from 1 to 95 years, and most of the patients (66.7%) were between 10 and 49 years of age. The male to female ratio was 2.6 : 1. Blunt injuries (129 cases, 95.6%) were frequent in motor-vehicle-related injuries (74 cases, 54.8%). The overall mortality rate was 14.1%. GCS, TS, t-RTS, RTS, ISS and the probability of survival by TRISS showed a statistical significance between the surviving and the expired groups (p<0.01) and can be used for obtaining a prognosis. In conclusion, TS, t-RTS, RTS, GCS, ISS, and the probability of survival by TRISS have a predictive value for trauma patient's health status as well as for prognosis and mortality. Those mentioned trauma scoring systems should facilitate the development of management protocols to improve future care.