Yousefzadeh-Chabok Shahrokh, Hosseinpour Marieh, Kouchakinejad-Eramsadati Leila, Ranjbar Fatemeh, Malekpouri Reza, Razzaghi Alireza, Mohtasham-Amiri Zahra
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.
Ulus Travma Acil Cerrahi Derg. 2016 Nov;22(6):536-540. doi: 10.5505/tjtes.2016.93288.
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.
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.
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.
TRISS was the strongest predictor of mortality in elderly trauma patients as result of combination of both anatomical and physiological parameters.
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。
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。
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%。
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。
