Evaluation of Revised Trauma Score in Polytrauma

Abstract

Objectives: This study aims to improve the management processes of polytrauma patients by evaluating the Revised Trauma Score (RTS) in predicting trauma outcomes by studying the incidence of mortality, intensive care unit (ICU) need and duration of hospital stay.
 Methods: Our study had carried out fifty patients with polytrauma examined at Emergency and Traumatology Department, Tanta University Hospital in the period between beginning of December 2020 to beginning of December 2021. Including all polytraumatized patients with age ≥18 years and excluding patients who arrived dead or who had significant co-morbidity.
 Results: The mean RTS value for survival was 7.05 (min-max=5.67-7.84), and was 4.73 (min-max=1.96-6.9) in non-survivals. Mean GCS for survival was 13.1 (min-max=8-15), and was 7.13 (min-max=3-13) in non-survivals.
 The mortality prediction of the GCS, RR and SBP were also compared using univariate logistic regression. The OR of the actual GCS score was 0.492 (p <0.001; 95% CI, 0.338 – 0.714). While was 0.940 (p =0.005; 95% CI, 0.910-0.983) for SBP and 0.892 (p =0.023; 95% CI, 0.809 – 0.985) for RR.
 When the performances of the RTS in predicting in-hospital mortality was evaluated through ROC analysis, the AUC was 0.919 (95% CI 0.806 to 0.977) (p<0.001).
 Conclusion: RTS is a good predictor of prognosis among trauma patients. The lower the RTS is significantly associated with a higher mortality and long hospital stay. Early evaluation of the injury level can be effective in patients' management. The revised trauma score is a reliable indicator of prognosis of polytraumatized patients. Therefore, it can be used for field and emergency room triage.