Clinical Significance of the Triage-revised Trauma Score in the Triage of Geriatric Trauma Patients

Yang, Young Mo; Ha, Young Rock; Chung, Sung Pil; Kim, Seung Hwan; Yoo, In Sool

Abstract

BACKGROUNDS: The mortality of geriatric trauma patients is higher than that of other age groups. However, little research has been done the methods or criteria of triage for geriatric trauma patients. This study evaluated a clinical significance of the triage-revised trauma score(t-RTS) for triage of geriatric trauma patients.
METHODS
We retrospectively analyzed clinical data on 528 trauma patients over 65 years of age who were treated from Jan 1999 to Dec 2000. The t-RTS was calculated utilizing the RR(respiratory rate), SBP(systolic BP), and GCS scores and the ISS was abstracted from the final diagnosis. The obtained t-RTS and ISS were evaluated using the measures of sensitivity, specificity, accuracy, and AUC curve.
RESULTS
The overall mortality rate was 9%, and there was no significant differences between the survival group and the mortality group according to age and sex. The mean scores of SBP, RR and GCS of the survival group were significantly higher than those of mortality group(p=0.001). The mean of t-RTS and RTS of the survival group were also significantly higher(p=0.001), but the ISS was significantly higher in the mortality group(p=0.001). The t-RTS, RTS, and ISS showed good prediction rates on the ROC curve(p=0.001), and the AUC value was higher in the ISS than in the t-RTS and the RTS. The sensitivity and the accuracy were high in the t-RTS and the RTS, and the specificity was high in the ISS. The t-RTS is less than 10 for a survival probability of 50% or less CONCLUSONS: Implementation of the t-RTS in the triage of geriatric trauma patients in the field and in emergency room would be very useful. The probability of death in geriatric trauma patients is high when the t-RTS is less than 10.