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创伤评分在预测创伤患者死亡率和发病率方面的比较。

Comparison of trauma scores for predicting mortality and morbidity on trauma patients.

作者信息

Orhon Reyhan, Eren Sevki Hakan, Karadayı Sule, Korkmaz Ilhan, Coşkun Abuzer, Eren Mehmet, Katrancıoğlu Nurkay

机构信息

Department of Emergency Medicine, Gaziantep State Hospital; Gaziantep, Turkey.

Department of Emergency Medicine, Cumhuriyet University Hospital, Sivas, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2014 Jul;20(4):258-64. doi: 10.5505/tjtes.2014.22725.

Abstract

BACKGROUND

In this study, we compared the anatomical, and physiological scoring systems trauma revised injury severity score (TRISS), revised trauma score (RTS), injury severity score (ISS), new injury severity score (NISS) to each other, to find out the most accurate and reliable trauma score for the risk classification of morbidity and mortality among the trauma patients.

METHODS

This is a cross-sectional study, which included 633 patients who admitted to our University Hospital Emergency Department during an 8-month period due to trauma. All blunt and penetrating traumas (traffic accident, assault, etc.) patients above 16 years were included.

RESULTS

Arrival time trauma scores (ISS, NISS, RTS, and TRISS) of the patients was calculated. Mean trauma score for the mortality prediction was calculated, and the p value was equal for all (p=0.001). Trauma scores were also analyzed for the hospitalization time in intensive care unit (ICU). While NISS, RTS, and TRISS values were significant (p=0.048, p=0.048, and p=0.017, respectively), ISS value was not significant (p=0.257) for predicting the ICU hospitalization time. Only TRISS was a good predictor for the mechanically ventilation time in ICU patients (p=0.01).

CONCLUSION

In conclusion, we determined that the anatomical trauma scores (NISS, ISS) predicted the hospitalization and ICU necessities better, whereas TRISS, an anatomo-physiological trauma score, defined the ICU hospitalization and mechanically ventilation time better.

摘要

背景

在本研究中,我们将解剖学和生理学评分系统——创伤修订损伤严重度评分(TRISS)、修订创伤评分(RTS)、损伤严重度评分(ISS)、新损伤严重度评分(NISS)相互比较,以找出用于创伤患者发病率和死亡率风险分类的最准确、最可靠的创伤评分。

方法

这是一项横断面研究,纳入了在8个月期间因创伤入住我校医院急诊科的633例患者。纳入所有16岁以上的钝性和穿透性创伤(交通事故、袭击等)患者。

结果

计算患者到达时的创伤评分(ISS、NISS、RTS和TRISS)。计算死亡率预测的平均创伤评分,所有评分的p值均相等(p = 0.001)。还分析了创伤评分与重症监护病房(ICU)住院时间的关系。对于预测ICU住院时间,NISS、RTS和TRISS值具有显著性(分别为p = 0.048、p = 0.048和p = 0.017),而ISS值无显著性(p = 0.257)。只有TRISS是ICU患者机械通气时间的良好预测指标(p = 0.01)。

结论

总之,我们确定解剖学创伤评分(NISS、ISS)能更好地预测住院需求和ICU需求,而解剖生理学创伤评分TRISS能更好地确定ICU住院时间和机械通气时间。

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