Correlation Between the Revised Trauma Score and Injury Severity Score: Implications for Prehospital Trauma Triage

Galvagno, Samuel M.; Massey, Michael S.; Bouzat, Pierre; Vesselinov, Roumen; Levy, Matthew J.; Millin, Michael G.; Stein, Deborah M.; Scalea, Thomas M.; Hirshon, Jon Mark

doi:10.1080/10903127.2018.1489019

Cited by 71 publications

(56 citation statements)

References 25 publications

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“…According to ACS-COT recommendations, the over-triage rate of between 25-50% and under-triage rate of <5% are considerated as approvable [6]. The Polish criteria do not take into consideration the mechanism of injury, which is a relevant predictive indicator of severe or extremely severe injuries (ISS>15) [8,13]. Furthermore, Polish criteria demand the simultaneous fulfilment of four different criteria (2 anatomical and 2 physiological), whereas each of them individually correlates with sustaining severe injuries.…”

Section: Discussionmentioning

confidence: 99%

Comparison of American guidelines for field triage and Polish criteria as qualification to a trauma center

Nowakowski

Biliński

et al. 2019

Ann Agric Environ Med.

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Section: Discussionmentioning

confidence: 99%

Comparison of American guidelines for field triage and Polish criteria as qualification to a trauma center

Nowakowski

Biliński

et al. 2019

Ann Agric Environ Med.

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“…The physiological scoring systems, e.g., the revised trauma score (RTS), the Glasgow coma scale (GCS), and the acute physiology and chronic health evaluation (APACHE). Or the combined scoring systems, e.g., the trauma and injury severity score (TRIS S), the organ injury scale (OIS), the international classification of diseases-based ISS (ICISS), a severity characterization of trauma (ASCOT), the trauma and injury severity score comorbidity (TRISSCOM) and the advanced trauma life support (ATLS) [11][12][13][14][15][16][17][18][19].…”

Section: Importancementioning

confidence: 99%

A descriptive study of orthopaedic injuries due to parachute jumping in soldiers

Şahin

Batın

2020

BMC Emerg Med

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Background: While parachute jumping, soldiers may suffer minor or life-threatening injuries in various parts of the body. Several trauma scoring systems assess the severity of such injuries. The primary goal of this study was to assess clinical characteristics and the severity of orthopaedic, musculoskeletal, and other injuries from military training-related parachute jumping using two trauma scoring systems (AIS and ISS). Our secondary goal was to assess whether there was an increase in injury rates with age. Methods: In total, 185 military personnel between 19 and 51 years old who were injured as a result of daytime static parachute jumping during 44 months between January 2016 and August 2019 were included in the study. Demographic data; vital signs; the level of consciousness; the Glasgow Coma Scale; ISS trauma region classifications; anatomical injury sites; AIS and ISS scores; diagnoses; treatment methods; hospitalization status; and duration of hospital stay were examined descriptively. Results: There were 184 male and one female participant. The most commonly injured body site was the foot (33.5%), and the most common diagnosis was soft tissue trauma (64.3%). The most commonly injured body site was the foot (33.5%), and the most common diagnosis was soft tissue trauma (64.3%). Regarding treatment methods, 51.4% received analgesic pills and cold pack application, 42.7% received a plaster splint, and 5.9% had orthopaedic surgery. The mean ISS score was 5.16 ± 3.92. The hospitalization rate was significantly higher for patients with a critical AIS score than those with a severe AIS score (p < 0.001). Conclusions: The use of trauma scoring systems to assess injury severity among patients admitted to an ED due to a parachute jumping injury may facilitate treatment selection. We found that AIS and ISS were useful in determining injury severity. Therefore, we recommend the use of trauma scoring systems for assessing the injury severity and the therapeutic approach, and we advocate for the use of the 17 anatomical regions we used in this study. We also found that with increasing age, the severity of injury could increase.

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“…These scores incorporate age, physiological variables (e.g., heart rate), and neurological variables (e.g., the Glasgow coma scale (GCS)) to identify injury severity. RTS may help in decision-making for hospital discharge and intensive care unit (ICU) admission (Mansour, Eisha & Asaad, 2019), but its accuracy in predicting mortality decreases with increasing age (Kojima et al, 2019) and exhibits poor correlation with anatomical injury severity (Galvagno Jr et al, 2019). APACHE II has proven to be a good predictor of mortality among brain injury patients (Nik et al, 2018), but it is inefficient for trauma triage in EDs because it has too many variables; its calculation requires 14 variables.…”

Section: Introductionmentioning

confidence: 99%

An improved modified early warning score that incorporates the abdomen score for identifying multiple traumatic injury severity

Jiang

2020

PeerJ

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Background Rapid identification of trauma severity is essential for the timely triage of multiple trauma patients. Tools such as the modified early warning score (MEWS) are used for determining injury severity. Although the conventional MEWS is a good predictor of mortality, its performance assessing injury severity is moderate. This study hypothesized that adding an injury site severity-related score (e.g., abdomen score) may enhance the capability of the MEWS for identifying severe trauma. Method To validate the hypothesis, we propose an improved modified early warning score called MEWS-A, which incorporates an injury site-specific severity-related abdomen score to MEWS. The utility of MEWS and MEWS-A were retrospectively evaluated and compared for identifying trauma severity in adult multiple trauma patients admitted to the emergency department. Results We included 1,230 eligible multiple trauma patients and divided them into minor and severe trauma groups based on the injury severity score. Results of logistic regression and receiver operating characteristic (ROC) curve analyses showed that the MEWS-A had a higher area under the ROC curve (AUC: 0.81 95% CI [0.78–0.83]) than did the MEWS (AUC: 0.77 95% CI [0.74–0.79]), indicating that the MEWS-A is superior to the MEWS in identifying severe trauma. The optimal MEWS-A cut-off score is 4, with a specificity of 0.93 and a sensitivity of 0.54. MEWS-A ≥ 4 can be used as a protocol for decision-making in the emergency department. Conclusions Our study suggests that while the conventional MEWS is sufficient for predicting mortality risk, adding an injury site-specific score (e.g., abdomen score) can enhance its performance in determining injury severity in multiple trauma patients.

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Correlation Between the Revised Trauma Score and Injury Severity Score: Implications for Prehospital Trauma Triage

Cited by 71 publications

References 25 publications

Comparison of American guidelines for field triage and Polish criteria as qualification to a trauma center

Comparison of American guidelines for field triage and Polish criteria as qualification to a trauma center

A descriptive study of orthopaedic injuries due to parachute jumping in soldiers

An improved modified early warning score that incorporates the abdomen score for identifying multiple traumatic injury severity

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