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根据创伤和损伤严重程度评分(TRISS)对创伤患者的预后评估:一项诊断准确性研究。

Prognosis of the Trauma Patients According to the Trauma and Injury Severity Score (TRISS); A Diagnostic Accuracy Study.

作者信息

Hosseinpour Reza, Barghi Amir, Mehrabi Saadat, Salaminia Shirvan, Tobeh Paria

机构信息

Department of General Surgery, Clinical Research Development Unit of Beheshti Hospital, Yasuj University of Medical Sciences, Yasuj, Iran.

Clinical Research Development Unit of Beheshti Hospital, Yasuj University of Medical Sciences, Yasuj, Iran.

出版信息

Bull Emerg Trauma. 2020 Jul;8(3):148-155. doi: 10.30476/BEAT.2020.84613.

Abstract

OBJECTIVE

To investigate the prognosis and survival rates of a group of Iranian patients with traumatic injuries using the trauma and injury severity score (TRISS) model.

METHODS

In this prospective cohort study, all the patients with multi-trauma referring to the Yasuj Shahid Beheshti hospital during 2018 were included. The patients' demographic information, trauma and history of previous illness were recorded. Vital symptoms including respiratory rate, heart rate, hypertension, pulse rate and Glasgow coma scale (GCS) score were assessed. The injury severity score (ISS) was calculated based on the type and location of the injuries and according to the abbreviated injury scale (AIS) classification. The survival probability of the patients was assessed according to the TRISS model.

RESULTS

Overall, 252 trauma patients were evaluated out of whom, 195 (77.4%) were men and 57 (22.6%) women. If we consider the TRISS score probability above 0.5 as the chance of being alive, the mortality rate was 6.75%, that was lower than our series (7.1%). The ISS score and GCS had a positive significant relationship with other variables except respiratory rate, body temperature and hospitalization. Revised trauma score (RTS) was significantly associated with other variables including age, GCS, hemoglobin, systolic blood pressure and respiratory rate. TRISS had an area under curve (AUC) of 0.988 indicating a high prognostic accuracy.

CONCLUSION

The mortality rate was lower than that of being predicted by TRISS. This might be due to treatment effectiveness and care for traumatic patients leading to decreased mortality. TRISS had high prognostic accuracy in trauma patients. We also reported an association between hemoglobin and survival rate. Therefore, it seems that considering the laboratory parameters can be useful in patients with trauma.

摘要

目的

使用创伤和损伤严重程度评分(TRISS)模型研究一组伊朗创伤患者的预后和生存率。

方法

在这项前瞻性队列研究中,纳入了2018年期间转诊至亚苏杰沙希德贝赫什提医院的所有多发伤患者。记录患者的人口统计学信息、创伤情况和既往病史。评估生命体征,包括呼吸频率、心率、血压、脉搏率和格拉斯哥昏迷量表(GCS)评分。根据损伤类型和部位,按照简明损伤定级标准(AIS)分类计算损伤严重程度评分(ISS)。根据TRISS模型评估患者的生存概率。

结果

总体而言,共评估了252例创伤患者,其中195例(77.4%)为男性,57例(22.6%)为女性。如果将TRISS评分概率高于0.5视为存活机会,死亡率为6.75%,低于我们系列研究中的死亡率(7.1%)。ISS评分和GCS与除呼吸频率、体温和住院时间外的其他变量呈显著正相关。改良创伤评分(RTS)与包括年龄、GCS、血红蛋白、收缩压和呼吸频率在内的其他变量显著相关。TRISS的曲线下面积(AUC)为0.988,表明预后准确性较高。

结论

死亡率低于TRISS预测值。这可能是由于对创伤患者的治疗效果和护理导致死亡率降低。TRISS在创伤患者中具有较高的预后准确性。我们还报告了血红蛋白与生存率之间的关联。因此,考虑实验室参数似乎对创伤患者有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8330/7468220/1cef506f8be1/bet-8-148-g001.jpg

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