Pillgram-Larsen J, Schistad P, Svennevig J L, Solheim K, Nordby H K
Kirurgisk avdeling, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1990 May 20;110(13):1673-6.
Functional status expressed as Trauma Score (TS) and mechanism of injury were evaluated as criteria for diagnosing severe trauma in 253 traffic accident victims. An Injury Severity Score (ISS) of greater than or equal to 16 was considered a severe, potentially life-threatening injury. In 67 patients with ISS greater than or equal to 16, either TS was less than or equal to 13 or the history suggested risk of high energy trauma in 72%. When one or both of these criteria were met, ISS was greater than or equal to 16 in 54%. In addition, five patients (3%) with ISS less than 16 had potentially life-threatening injuries in the abdomen or in the thorax. Of these, two had a history indicating high energy trauma. Identifying severely injured patients by assessment of function and mechanism of injury gave an overtriage of 46%, which is acceptable, and an undertriage of 12%. Caution should be exercised in excluding severe trauma on these criteria. Considered together, decreased TS and a history indicating high energy injury, gave high sensitivity (72%) and specificity (78%) for diagnosing severe trauma, ISS greater than or equal to 16.
以创伤评分（TS）表示的功能状态和损伤机制被评估为253名交通事故受害者严重创伤的诊断标准。损伤严重程度评分（ISS）大于或等于16被视为严重的、可能危及生命的损伤。在67名ISS大于或等于16的患者中，72%的患者TS小于或等于13或病史提示有高能创伤风险。当满足这些标准中的一项或两项时，54%的患者ISS大于或等于16。此外，5名（3%）ISS小于16的患者在腹部或胸部有潜在危及生命的损伤。其中，两名患者有提示高能创伤的病史。通过评估功能和损伤机制来识别重伤患者，过度分诊率为46%，这是可以接受的，漏诊率为12%。在根据这些标准排除严重创伤时应谨慎。综合考虑，TS降低和提示高能损伤的病史对诊断严重创伤（ISS大于或等于16）具有高敏感性（72%）和特异性（78%）。
