Kim Seong Chun, Kim Dong Hoon, Kim Tae Yun, Kang Changwoo, Lee Soo Hoon, Jeong Jin Hee, Park Yong Joo, Lee Sang Bong, Lim Daesung
Department of Emergency Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
Department of Emergency Medicine, Gyeongsang National University School of Medicine, 15, Jinju-daero 816beon-gil, Jinju-si, Republic of Korea; Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, 15, Jinju-daero 816beon-gil, Jinju-si, Gyeongsangnam-do, Republic of Korea.
Am J Emerg Med. 2017 Dec;35(12):1882-1886. doi: 10.1016/j.ajem.2017.06.027. Epub 2017 Jun 15.
The Revised Trauma Score (RTS) is used worldwide in prehospital practice and in the emergency department (ED) settings to triage trauma patients. The main purpose of this study was to evaluate the value of the RTS plus serum albumin (RTS-A) and to compare it with other existing trauma scores as well as to compare the predictive performance of the Trauma and Injury Severity Score with the RTS-A (TRISS-A) with the original TRISS.
This was a single center, trauma registry based observational cohort study. Data were collected from consecutive patients with blunt or penetrating injuries who presented to the emergency department of a tertiary referral hospital, between January 2012 and June 2016. 3145 and 2447 patients were assigned to the derivation group and validation group, respectively. Main outcome was in-hospital mortality.
Among patients in the derivation group, the median [interquartile range] age was 59 [43-73] years, and 66.7% were male. The area under the receiver operating characteristic curves (AUC) of the RTS-A (0.948; 95% CI: 0.939-0.955) was higher than that of the RTS (0.919; 95% CI: 0.909-0.929). In patients with blunt trauma, the AUC of the TRISS-A (0.960; 95% CI: 0.952-0.967) was significantly higher than that of the original TRISS (0.949; 95% CI: 0.941-0.957).
The value of the RTS-A predicts the in-hospital mortality of trauma patients better than the RTS, and the TRISS-A is a better mortality predictor compared to the original TRISS in patients with blunt trauma.
修订创伤评分（RTS）在全球范围内用于院前急救及急诊科对创伤患者进行分诊。本研究的主要目的是评估RTS加血清白蛋白（RTS-A）的价值，并将其与其他现有创伤评分进行比较，同时比较创伤和损伤严重程度评分与RTS-A（TRISS-A）和原始TRISS的预测性能。
这是一项基于创伤登记的单中心观察性队列研究。收集了2012年1月至2016年6月期间在一家三级转诊医院急诊科就诊的连续钝性或穿透性损伤患者的数据。分别将3145例和2447例患者分配到推导组和验证组。主要结局是院内死亡率。
在推导组患者中，年龄中位数[四分位间距]为59[43-73]岁，男性占66.7%。RTS-A的受试者工作特征曲线下面积（AUC）（0.948；95%CI：0.939-0.955）高于RTS（0.919；95%CI：0.909-0.929）。在钝性创伤患者中，TRISS-A的AUC（0.960；95%CI：0.952-0.967）显著高于原始TRISS（0.949；95%CI：0.941-0.957）。
RTS-A预测创伤患者院内死亡率的价值优于RTS，在钝性创伤患者中，TRISS-A比原始TRISS是更好的死亡率预测指标。
