Importance of using scales for assessing condition severe of patients with polytrauma

Abstract

The problem of treatment of patients with multiple and combined injuries remains one of the most relevant in modern medicine. According to modern statistical data, amount of traumas is growing worldwide, and among the able-bodied population polytrauma is one of the main causes for disablement and death. About 5 million people worldwide are injured every year, of which 15–21% have multiple and associated injuries. To improve the quality of medical care for patients with polytrauma and decrease the level of disablement and deaths, it is necessary to study the problem of rendering medical aid to patients with multiple and combined injuries. The purpose — to assess various scales of the condition severity of patients with polytrauma. Material and methods. A retrospective analysis of 120 patients was carried out, who from 2017 to 2020 were treated at City Clinical Hospital named after A.K. Eramishantsev, of them 66 (55%) women and 54 (45%) men. The age group was 25–75 years old. Results. One of the most adequate methods of assessing the condition severity of patients with polytrauma is a score-based approach, which allows determining the correct treatment tactics. Correct treatment tactics can reduce the time of disability, mortality and disability of patients. In modern traumatology and orthopedics, ISS scale is considered the «gold standard» for assessing the condition severity, but many doctors and authors mark that this scale is insufficiently informative. Our comparative analysis revealed that the NISS scale has greater accuracy in predicting mortality than ISS, especially in critical patients and patients with blunt trauma. Conclusion. A clear definition of the polytrauma concept with a single score assessment system for assessing the condition severity will allow to standardize treatment tactics, conduct an adequate comparative analysis of treatment results, objectively resolve issues of organization and financial provision of medical care to seriously injured patients, improve the quality of medical care, reduce mortality and disability of the able-bodied population, and provide full recovery and return to normal standard of living. The creation of a unified assessment system is difficult, which is associated with the polyphocality of injuries. We believe that further in-depth studies of patients with multiple and combined trauma are needed to develop modern guidelines and clinical recommendations, as well as a unified single-score assessment system.