Gabbe Belinda J, Cameron Peter A, Finch Caroline F
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
ANZ J Surg. 2003 Nov;73(11):944-8. doi: 10.1046/j.1445-1433.2003.02833.x.
The revised trauma score (RTS) has been embraced by the trauma community worldwide. Although originally developed as a triage tool, the use of the RTS has since been expanded to include the prediction of outcome following traumatic injury. Through a critical review of the literature, evidence for use of the RTS is discussed along with the limitations of this commonly used tool. In summary, the RTS is a well-established predictor of mortality in trauma populations, but there is a lack of definitive evidence supporting its use as a primary triage tool and as a predictor of outcomes other than mortality. Difficulty in collecting the components of the RTS creates issues for data validity and the use of the RTS as a research tool. Although the weighted RTS has been developed to improve the prediction capacity of the RTS, studies reporting its use are few and there is debate regarding the applicability of the published coefficients for broad use. Overall, further studies are warranted to clearly establish the usefulness of the RTS as a triage tool in the field, to further evaluate the weighted version of the RTS, and to determine the ability of the RTS to predict functional outcome and quality of life. In particular, future research is needed to address these issues in Australian trauma populations.
修订创伤评分(RTS)已被全球创伤学界所采用。尽管最初是作为一种分诊工具开发的,但RTS的用途后来已扩展到包括预测创伤性损伤后的结局。通过对文献的批判性回顾,讨论了使用RTS的证据以及这一常用工具的局限性。总之,RTS是创伤人群死亡率的公认预测指标,但缺乏确凿证据支持将其用作主要分诊工具以及作为死亡率以外其他结局的预测指标。收集RTS各组成部分存在困难,这给数据有效性以及将RTS用作研究工具带来了问题。尽管已开发出加权RTS以提高RTS的预测能力,但报告其使用情况的研究很少,并且对于已发表系数的广泛适用性存在争议。总体而言,有必要进行进一步研究,以明确确定RTS作为现场分诊工具的实用性,进一步评估加权版RTS,并确定RTS预测功能结局和生活质量的能力。特别是,未来需要针对澳大利亚创伤人群的这些问题开展研究。