J Korean Soc Emerg Med.  2014 Aug;25(4):447-455. 10.0000/jksem.2014.25.4.447.

Application of New Trauma Scoring Systems for Mortality Prediction in Patients with Adult Major Trauma

Affiliations
  • 1Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. kssuh@knu.ac.kr
  • 2Department of Emergency Medicine, Gumi CHA Medical Center, CHA University, Gumi, Korea.

Abstract

PURPOSE
Various scoring systems have been introduced in grading severity and predicting mortality of trauma patients. The objective of this study is to apply novel trauma scoring systems; BIG score (Base deficit (B), International normalized ratio (I), Glasgow Coma Scale (G)), Emergency Trauma Score (EMTRAS), Probability of Survival score version 12 (PS12), and MGAP (Mechanism, GCS, Age, Arterial pressure) to adults with major trauma, and to compare their performance with traditional systems; Injury Severity System (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS).
METHODS
Retrospective data collected between January 2011 and June 2012 from a regional trauma center registry on adult major trauma patients (Age> or =18, ISS> or =16) were used to identify factors associated with death. Univariate associations were calculated, and a multiple logistic regression analysis was used to determine variables associated with hospital mortality.
RESULTS
A total of 298 adult major trauma patients were retrieved in order to validate new trauma scoring systems. The median ISS was 22 [interquartile range (IQR) 17~25], and the hospital mortality rate was 30.9%. Traditional trauma scoring systems were each calculated to have an area under the curve of ISS 0.72 [95% confidence interval (CI): 0.67-0.77], TRISS 0.91 (95% CI: 0.88-0.94), and RTS 0.90 (95% CI: 0.86-0.93). New trauma scoring systems were calculated to have an area under the curve of EMTRAS 0.91 (95% CI: 0.87-0.94), BIG score 0.90 (95% CI: 0.86-0.93), PS12 0.91 (95% CI: 0.87-0.94), and MGAP 0.89 (95% CI: 0.85-0.93).
CONCLUSION
The new trauma scoring systems (EMTRAS, BIG, MGAP) were good predictors of mortality in adult major trauma patients on admission. They performed well compared to traditional trauma scoring systems (ISS, RTS, TRISS).

Keyword

Triage; Adult; Injury severity score; Trauma severity indices; Fatal outcome

MeSH Terms

Adult*
Emergencies
Fatal Outcome
Glasgow Coma Scale
Hospital Mortality
Humans
Injury Severity Score
International Normalized Ratio
Logistic Models
Mortality*
Retrospective Studies
Trauma Centers
Trauma Severity Indices
Triage
Full Text Links
  • JKSEM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr