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Volume 2023, Issue 1
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Some measures have been proposed for the prediction of death after trauma; however, there is a lack of studies on this issue in trauma patients. Therefore, this study was conducted to compare the validity of four scales in predicting the death of trauma patients, and we hypothesized that the accuracies of various scales are different.

This descriptive-analytical study was conducted prospectively on 600 trauma patients admitted at the emergency ward of Imam Khomeini Hospital in Ilam, Ilam province, west of Iran. The subjects were selected by convenience sampling. Data were collected using the checklists developed for trauma patients, including the Full Outline of UnResponsiveness (FOUR) score, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS), and then the data were analyzed using the chi-square test and the area under the receiver operating characteristic curve (AUC).

Among the 600 patients, most of them were male (76.8%), with a mean and standard deviation of the age of 31.16 ± 18.06 years, and road traffic accident was the most common cause of trauma (73%). The FOUR scale was the most valid in predicting the mortality of trauma patients, and its sensitivity, specificity, positive and negative predictive values, and accuracy were equal to 93.2, 94.5, 64.7, 99.2, and 94.3%, respectively. The AUC was equal to 0.938 for the FOUR scale, followed by the RTS (0.787).

Results of the study about the predictive value of the scales for mortality prediction of trauma patients showed that the FOUR scale had the highest accuracy compared to other scales. Thus, for applying this scale in trauma and emergency centers, besides our results, further studies are needed to support the study findings.

© 2023 Vaisi raygani, Darabi, Jalali, Beiki, Abdi, licensee HBKU Press.
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2023-01-19
2024-11-09
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References

  1. Okasha A.S, Abouelea A, Hashish W. Prediction of outcome of poly traumatized patients using different Traumas scoring systems. J Am Sci. 2011: 7:(12):1.
     [Google Scholar]
  2. Davidson GH, Hamlat CA, Rivara FP, Koepsell TD, Jurkovich GJ, Arbabi S. Long-term survival of adult trauma patients. JAMA. 2011Mar9; 305:(10):1001−7.
     [Google Scholar]
  3. Razzaghi A, Soori H, Kavousi A, Abadi A, Khosravi AK, Alipour A. Risk factors of deaths related to road traffic crashes in World Health Organization regions: A systematic review. Arch Trauma Res. 2019Apr1; 8:(2):57−86.
     [Google Scholar]
  4. Rissanen R, Berg HY, Hasselberg M. Quality of life following road traffic injury: a systematic literature review. Accid Anal Prev. 2017Nov1; 108::308−20.
     [Google Scholar]
  5. Park CL. Spiritual well-being after trauma: Correlates with appraisals, coping, and psychological adjustment. J Prev Interv Community. 2017Oct2; 45:(4):297−307.
     [Google Scholar]
  6. Mariani A, Casella G, Aseni P. From trauma scoring system to early appropriate care. In: Aseni P, De Carlis L, Mazzola A, Grande AM. Editors. Operative techniques and recent advances in acute care and emergency surgery. Cham:Springer;2019:129−40.
     [Google Scholar]
  7. Beuran M, Negoi I, Păun S, Runcanu A, Gaspar B, Vartic M. Trauma scores: a review of the literature. Chirurgia (Bucharest, Romania: 1990). 2012May1; 107:(3):291−7.
     [Google Scholar]
  8. Oyetunji T, Crompton JG, Efron DT, Haut ER, Chang DC, Cornwell III EE, et al. Simplifying physiologic injury severity measurement for predicting trauma outcomes. J Surg Res. 2010Apr1; 159:(2):627−32
     [Google Scholar]
  9. Chawda MN, Hildebrand F, Pape HC, Giannoudis PV. Predicting outcome after multiple trauma: which scoring system?Injury. 2004Apr1; 35:(4):347−58.
     [Google Scholar]
  10. Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974Jul13; 304:(7872):81−4.
     [Google Scholar]
  11. Reith FC, Brennan PM, Maas AI, Teasdale GM. Lack of standardization in the use of the Glasgow coma scale: results of international surveys. J Neurotrauma. 2016Jan1; 33:(1):89−94.
     [Google Scholar]
  12. Valderrama-Molina CO, Giraldo N, Constain A, Puerta A, Restrepo C, León A, et al. Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population. Eur J Orthop Surg Traumatol. 2017Feb1; 27:(2):213−20.
     [Google Scholar]
  13. Domingues CD, Nogueira LD, Settervall CH, Sousa RM. Performance of trauma and injury severity score (TRISS) adjustments: an integrative review. Rev Esc Enferm USP. 2015; 49::138−46.
     [Google Scholar]
  14. Jalali R, Rezaei M. A comparison of the Glasgow coma scale score with full outline of unresponsiveness scale for prediction of patients’ traumatic brain injury early outcomes in intensive care units. Crit Care Res Pract. 2014; 2014::289803.
     [Google Scholar]
  15. Kasprowicz M, Burzynska M, Melcer T, Kübler A. A comparison of the Full Outline of UnResponsiveness (FOUR) score and Glasgow Coma Score (GCS) in predictive modelling in traumatic brain injury. Br J Neurosurg. 2016Mar3; 30:(2):211−20.
     [Google Scholar]
  16. Ramazani J, Hosseini M. Prediction of ICU mortality in critically ill children. Med Klin - Intensivmed Notfallmed. 2019Nov1; 114:(8):717−23.
     [Google Scholar]
  17. Salah R, Fakhri T, Gaber A. Full outline of unresponsiveness versus Glasgow coma scale in predicting mortality in paediatric trauma patients. Int Surg J. 2019Jun29; 6:(7):2279−85.
     [Google Scholar]
  18. Ghelichkhani P, Esmaeili M, Hosseini M, Seylani K. Glasgow Coma Scale and FOUR Score in predicting the mortality of trauma patients; a diagnostic accuracy study. Emergency. 2018; 6:(1):e42.
     [Google Scholar]
  19. Hosseini SH, Ayyasi M, Akbari H, Gorji MA. Comparison of Glasgow coma scale, full outline of unresponsiveness and acute physiology and chronic health evaluation in prediction of mortality rate among patients with traumatic brain injury admitted to intensive care unit. Anesth Pain Med. 2017Oct; 7:(5):e33853.
     [Google Scholar]
  20. Baratloo A, Mirbaha S, Bahreini M, Banaie M, Safaie A. Outcome of trauma patients admitted to emergency department based on full outline of unresponsiveness score. Adv J Emerg Med. 2017Oct9; 1:(1):e2.
     [Google Scholar]
  21. Hickisch A, Holmefur M. Swedish translation and reliability of the full outline of Unresponsiveness Score. J Neurosci Nurs. 2016Jul1; 48:(4):195−205.
     [Google Scholar]
  22. Nyam TT, Ao KH, Hung SY, Shen ML, Yu TC, Kuo JR. FOUR score predicts early outcome in patients after traumatic brain injury. Neurocrit Care. 2017Apr1; 26:(2):225−31.
     [Google Scholar]
  23. Anestis DM, Tsitsopoulos PP, Tsonidis CA, Foroglou N. The current significance of the FOUR score: A systematic review and critical analysis of the literature. J Neurol Sci. 2019Nov27; 409::116600.
     [Google Scholar]
  24. Foo CC, Loan JJ, Brennan PM. The relationship of the FOUR score to patient outcome: a systematic review. J Neurotrauma. 2019Sep1; 36:(17):2469−83.
     [Google Scholar]
  25. Alvarez BD, Razente D, Lacerda DAM, Lother NS, VON-Bahten LC, Stahlschmidt CMM. Analysis of the Revised Trauma Score (RTS) in 200 victims of different trauma mechanisms. Rev Col Bras Cir. 2016Oct; 43:(5):334−40.
     [Google Scholar]
  26. Huang YT, Huang YH, Hsieh CH, Li CJ, Chiu IM. Comparison of Injury Severity Score, Glasgow Coma Scale, and Revised Trauma Score in predicting the mortality and prolonged ICU stay of traumatic young children: A cross-sectional retrospective study. Emerg Med Int. 2019Dec1; 2019::5453624.
     [Google Scholar]
  27. Galvagno Jr 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. Prehosp Emerg Care. 2019Mar4; 23:(2):263−70.
     [Google Scholar]
  28. Jeong JH, Park YJ, Kim DH, Kim TY, Kang C, Lee SH, et al. The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction. BMC Surg. 2017Dec1; 17:(1):77.
     [Google Scholar]
  29. Wijdicks EF, Rabinstein AA, Bamlet WR, Mandrekar JN. FOUR score and Glasgow Coma Scale in predicting outcome of comatose patients: A pooled analysis. Neurology. 2011; 77::84−5.
     [Google Scholar]
  30. Javali RH, Krishnamoorthy AP, Srinivasarangan M, Suraj S. 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. 2019Feb; 23:(2):73.
     [Google Scholar]
  31. Yadollahi M, Kashkooe A, Rezaiee R, Jamali K, Niakan MH. A comparative study of Injury Severity Scales as predictors of mortality in trauma patients: Which scale is the best?Bull Emerg Trauma. 2020Jan; 8:(1):27.
     [Google Scholar]
  32. Majdan M, Plancikova D, Brazinova A, Rusnak M, Nieboer D, Feigin V, et al. Epidemiology of traumatic brain injuries in Europe: a cross-sectional analysis. Lancet Public Health. 2016Dec1; 1:(2):e76−83.
     [Google Scholar]
  33. Guzzo JL, Bochicchio GV, Napolitano LM, Malone DL, Meyer W, Scalea TM. Prediction of outcomes in trauma: anatomic or physiologic parameters?J Am Coll Surg. 2005Dec1; 201:(6):891−7.
     [Google Scholar]
  34. AL-Naami MY, Sadik AA, Adam MA. Evaluation of trauma registry data in Asir region. Saudi Med J. 2001; 22:(5):438−43.
     [Google Scholar]
  35. Akapivate P, Sookplung P, Kaewsingha P, Maunsaiyat P. Prediction of discharge outcome with the Full Outline of Unresponsiveness (FOUR) Score in neurosurgical patients. Acta Med Okayama. 2011(3): 65::205−10.
     [Google Scholar]
  36. Carvalho A, Junior A. Characterization of trauma patient treated in a pre-hospital care service. Einsten. 2004; 2:(3):199−205.
     [Google Scholar]
  37. Azami-Aghdash S, Sadeghi-Bazargani H, Shabaninejad H, Gorji HA. Injury epidemiology in Iran: a systematic review. J Inj Violence Res. 2017Jan; 9:(1):27.
     [Google Scholar]
  38. Bilgin NG, Mert E, Camdeviren H. The usefulness of trauma scores in determining the life threatening condition of trauma victims for writing medical-legal reports. Emerg Med J. 2005; 22:(11):783−87.
     [Google Scholar]
  39. Marcati E, Ricci S, Casalena A, Toni D, Carolei A, Sacco S. Validation of the Italian version of a new coma scale: the FOUR score. Intern Emerg Med. 2012Apr; 7:(2):145−52.
     [Google Scholar]
/content/journals/10.5339/jemtac.2023.2
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Investigating RTS, TRISS, GCS, and FOUR as measures for predicting the mortality in trauma patients: A prospective study
Journal of Emergency Medicine, Trauma and Acute Care 2023, 2 (2023); https://doi.org/10.5339/jemtac.2023.2
/content/journals/10.5339/jemtac.2023.2
/content/journals/10.5339/jemtac.2023.2
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Keyword(s): FOUR, GCS, predictive validity, RTS, traumatic patients and TRISS

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