Arikan Ali Ahmet, Selçuk Emre, Bayraktar Fatih Avni
Kocaeli University Medical Faculty Department of Cardiovascular Surgery Kocaeli Turkey Department of Cardiovascular Surgery, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Muş State Hospital Department of Cardiovascular Surgery Muş Turkey Department of Cardiovascular Surgery, Muş State Hospital, Muş, Turkey.
Braz J Cardiovasc Surg. 2020 Apr 1;35(2):198-205. doi: 10.21470/1678-9741-2019-0403.
To compare the anatomical and physiological scoring systems and the outcomes of surgical management of penetrating cardiovascular trauma at a rural center.
Seventy-seven patients underwent emergency surgery at our center between January/2012 and October/2018 due to penetrating cardiovascular trauma. Injury Severity Score (ISS), Revised Trauma Score (RTS), New Injury Severity Score (NISS), and Trauma and Injury Severity Score (TRISS) were calculated. The validation of these risk scores to predict mortality was assessed by the area under the receiver operating characteristic curve analysis.
All trauma scores were correlated with mortality. As ISS, NISS, and TRISS values increased and RTS values decreased, the mortality rate increased. The area under the curve (AUC) in the receiver operating characteristic curve analysis was 0.943 for TRISS, 0.915 for RTS, 0.890 for ISS, and 0.896 for NISS (P<0.001 for each). Logistic regression analysis revealed that scores were correlated with mortality (P<0.001 for each). By investigating cardiac injuries alone, only TRISS and RTS results correlated with mortality for cardiac injuries (Mann-Whitney U test, P=0.003 and P=0.01, respectively). The AUC was only statistically significant for TRISS and RTS (AUC=0.929, P<0.05 for both). For vascular injuries, all the scores were significantly correlated with in-hospital mortality (Mann-Whitney U test, P<0.001 for each). TRISS had the highest AUC (AUC=0.946, P<0.001).
TRISS has the highest predictivity for in-hospital mortality in patients with penetrating cardiovascular trauma.
比较农村中心穿透性心血管创伤的解剖和生理评分系统以及手术治疗结果。
2012年1月至2018年10月期间，77例因穿透性心血管创伤在本中心接受急诊手术的患者。计算损伤严重度评分（ISS）、修订创伤评分（RTS）、新损伤严重度评分（NISS）和创伤与损伤严重度评分（TRISS）。通过受试者工作特征曲线分析下的面积评估这些风险评分预测死亡率的有效性。
所有创伤评分均与死亡率相关。随着ISS、NISS和TRISS值增加以及RTS值降低，死亡率上升。受试者工作特征曲线分析中曲线下面积（AUC），TRISS为0.943，RTS为0.915，ISS为0.890，NISS为0.896（各P<0.001）。逻辑回归分析显示评分与死亡率相关（各P<0.001）。单独研究心脏损伤时，仅TRISS和RTS结果与心脏损伤死亡率相关（曼-惠特尼U检验，分别为P=0.003和P=0.01）。AUC仅TRISS和RTS有统计学意义（AUC=0.929，两者P<0.05）。对于血管损伤，所有评分均与院内死亡率显著相关（曼-惠特尼U检验，各P<0.001）。TRISS的AUC最高（AUC=0.946，P<0.001）。
TRISS对穿透性心血管创伤患者的院内死亡率预测性最高。
