DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20170627

A prospective study of trauma patients at Gandhi Medical College and associated hospital emergency department, Bhopal, analysing anatomical and physiological scoring systems to predict mortality

Moorat Singh Yadav, Vibhore Agarwal, Surabhi Garg

Abstract


Background: Trauma, in a developing country like India, is a leader together with non-communicable diseases, when measured in terms of disability adjusted life years (DALYs) lost. Trauma scoring systems have been shown to decrease the number of preventable deaths caused by trauma. The aim of this study is to compare the various physiological and anatomical scoring systems.

Methods: Two hundred and sixty two cases of trauma of adult age group admitted in Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India from 1 July 2014 to 1 December 2014.

Results: Out of the 262 patients included in the study, 242 were discharged alive while 20 (7.6%) died. In our study, in of the patients who died it was observed that RTS was significantly low (<7) and ISS and TRISS were significantly high (>/=25 for ISS and >/=50 for TRISS).

Conclusions: Of all the scoring system TRISS has got the best sensitivity, specificity and positive predictive value of 83.3% and also miscalculation rate of 1.5 as per the MOTS norms as compared to RTS, which has sensitivity of 90% but low specificity, and ISS which has sensitivity and specificity comparable to TRISS but low positive predictive value.


Keywords


DALY, Glasgow Coma Scale, TRISS

Full Text:

PDF

References


Sidhu DS, Sodi GS, Bannerjee AK. Mortality profile in trauma victims. J Indian Med Assoc. 1993;91:16-8.

Posaw LL, Aggarwal P, Bernstein SL. Emergency medicine in the New Delhi area, India. Ann Emerg Med. 1998;32:609-15.

Mock CN, Jurkovich GJ, Kotei D, Arreola RC, Maier RV. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma. 1998;44(5):804-12.

Gumber A. Burden of injury in India. Econ Pol Wkly. 1997:32(5):1478-91.

Shackford SR, Mackersie RC, Hoyt DB, Baxt WG, Eastman AB, Hammill FN, et al. Impact of a trauma system on outcome of severely injured patients. Arch Surg. 1987;122(5):523-7.

Bouillon B, Lefering R, Vorweg M, Tiling T, Neugebauer E, Troidl H. Trauma score system. Cologne Validation study. J Trauma. 1997;42:652-8.

Sammour T, Kahokehr A, Caldwell S, Hill AG. Venous glucose and arterial lactate as biochemical predictors of mortality in clinically severely injured trauma patients- a comparison with ISS and TRISS. Injury. 2009;40:104-8.

Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flanagan ME. A Revision of the Trauma Score. J Trauma. 1989;29(5):623-9.

Gennarelli TA, Wodzin E. AIS 2005: A contemporary injury scale. Injury. 2006;37:1083-91.

Champion HR, Sacco WJ, Carnazzo AJ, Copes W, Fouty WJ. Trauma score. Crit Care Med. 1981;9:672-6.

Boyd CR, Tolson MA, Copes WS. Evaluating trauma care: The TRISS method. Trauma Score and the Injury Severity Score. J Trauma. 1987;27:370-8.

Champion HR, Sacco WJ, Hannan DS, Lepper RL, Atzinger ES, Copes WS, et al. Assessment of injury severity: The Triage index. Crit Care Med. 1980;8:201-8.

Baker SP, O'Neill B, Haddon W Jr, Long WB. The Injury Severity Score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187-96.

Hariharan S, Chen D, Parker K, Figari A, Lessey G, Absolom D, et al. Evaluation of trauma care applying TRISS methodology in a Caribbean developing country. J Emerg Med. 2009;37:85-90.