修订创伤评分、损伤严重度评分和创伤与损伤严重度评分在老年创伤患者死亡率预测中的比较
Comparison of Revised Trauma Score, Injury Severity Score and Trauma and Injury Severity Score for mortality prediction in elderly trauma patients.
作者信息
Yousefzadeh-Chabok Shahrokh, Hosseinpour Marieh, Kouchakinejad-Eramsadati Leila, Ranjbar Fatemeh, Malekpouri Reza, Razzaghi Alireza, Mohtasham-Amiri Zahra
机构信息
Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht-Iran, Department of Social and Preventive Medicine, Guilan University of Medical Sciences, Rasht-Iran.
出版信息
Ulus Travma Acil Cerrahi Derg. 2016 Nov;22(6):536-540. doi: 10.5505/tjtes.2016.93288.
BACKGROUND
Trauma is the fifth leading cause of death in patients 65 years and older. This study is a comparison of results of Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) in prediction of mortality in cases of geriatric trauma.
METHODS
This is a cross-sectional study of records of 352 elderly trauma patients who were admitted to Pour-Sina Hospital in Rasht between 2010 and 2011. Injury scoring systems were compared in terms of specificity, sensitivity, and cut-off points using receiver operating characteristic curve of patient prognosis.
RESULTS
Mean age of patients was 71.5 years. Most common mechanism of injury was traffic accident (53.7%). Of the total, 13.9% of patients died. Mean ISS was higher for patients who did not survive. Mean of TRISS and RTS scores in elderly survivors was higher than non-survivors and difference in all 3 scores was statistically significant (p<0.001). Best cut-off points for predicting mortality in elderly trauma patients in RTS, ISS, and TRISS systems were ≤6, ≥13.5, and ≤2, with sensitivity of 99%, 84%, and 95% and specificity of 62%, 62%, and 72%, respectively.
CONCLUSION
TRISS was the strongest predictor of mortality in elderly trauma patients as result of combination of both anatomical and physiological parameters.
背景
创伤是65岁及以上患者死亡的第五大主要原因。本研究比较了修订创伤评分（RTS）、损伤严重程度评分（ISS）和创伤与损伤严重程度评分（TRISS）在预测老年创伤患者死亡率方面的结果。
方法
这是一项对2010年至2011年期间入住拉什特市普尔 - 西纳医院的352例老年创伤患者记录的横断面研究。使用患者预后的受试者工作特征曲线，从特异性、敏感性和临界点方面比较损伤评分系统。
结果
患者的平均年龄为71.5岁。最常见的损伤机制是交通事故（53.7%）。总共有13.9%的患者死亡。未存活患者的平均ISS更高。老年幸存者的TRISS和RTS评分均值高于非幸存者，且所有三项评分的差异均具有统计学意义（p<0.001）。RTS、ISS和TRISS系统中预测老年创伤患者死亡率的最佳临界点分别为≤6、≥13.5和≤2，敏感性分别为99%、84%和95%，特异性分别为62%、62%和72%。
结论
由于结合了解剖学和生理学参数，TRISS是老年创伤患者死亡率最强的预测指标。
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