Stoica Bogdan, Paun Sorin, Tanase Ioan, Negoi Ionut, Chiotoroiu Alexandru, Beuran Mircea
Chirurgia (Bucur). 2016 Mar-Apr;111(2):115-9.
A mixed score to predict the probability of survival has a key role in the modern trauma systems. The aim of the current studies is to summarize the current knowledge about estimation of survival in major trauma patients, in different trauma registries.
Systematic review of the literature using electronic search in the PubMed/Medline, Web of Science Core Collection and EBSCO databases. We have used as a MeSH or truncated words a combination of trauma "probability of survival" and "mixed scores". The search strategy in PubMed was: "((((trauma(MeSH Major Topic)) OR injury(Title/Abstract)) AND score (Title/Abstract)) AND survival) AND registry (Title/Abstract))))". We used as a language selection only English language literature.
There is no consensus between the major trauma registries, regarding probability of survival estimation in major trauma patients. The German (RISC II), United Kingdom (PS Model 14) trauma registries scores are based of the largest population, with demographics updated to the nowadays European injury pattern. The revised TRISS, resulting from the USA National Trauma Database, seems to be inaccurate for trauma systems managing predominantly blunt injuries.
The probability of survival should be evaluated in all major trauma patients, with a score derived from a population which reproduce the current demographics.Only a careful audit of the unpredicted deaths may continuously improve our care for severely injured patients.
用于预测生存概率的综合评分在现代创伤系统中起着关键作用。当前研究的目的是总结不同创伤登记处关于主要创伤患者生存估计的现有知识。
通过在PubMed/Medline、科学网核心合集和EBSCO数据库中进行电子检索对文献进行系统综述。我们使用创伤“生存概率”和“综合评分”的组合作为医学主题词(MeSH)或截断词。PubMed中的检索策略为:“((((创伤(医学主题词主要主题))或损伤(标题/摘要))且评分(标题/摘要))且生存)且登记处(标题/摘要))))”。我们仅选择英文文献作为语言筛选范围。
在主要创伤登记处之间,对于主要创伤患者生存概率的估计没有达成共识。德国(RISC II)、英国(PS模型14)创伤登记处的评分基于最大的人群,其人口统计学数据已更新为当今欧洲的损伤模式。源自美国国家创伤数据库的修订版TRISS,对于主要处理钝性损伤的创伤系统而言似乎不准确。
所有主要创伤患者的生存概率都应使用源自能反映当前人口统计学特征人群的评分进行评估。只有对意外死亡进行仔细审核,才能持续改善我们对重伤患者的救治。