Prediction of outcomes in chest trauma patients using chest trauma scoring system: A prospective observational study

Abstract

Background and Aims:Prognostication of chest trauma patients by scoring systems is of vital importance to predict morbidity and mortality. We aimed to predict outcomes in chest trauma patients using chest trauma scoring system (CTS) in Indian patients.Methods:This was a prospective observational study done in a trauma care centre at a tertiary care teaching public hospital. CTS was calculated by scores of age, severity of pulmonary contusion, number of rib fractures and presence of bilateral rib fractures. Final CTS ranges from 2 to 12. We evaluated CTS to predict outcome that is mortality as primary objective and development of complications like pneumonia and need for ventilator support as secondary objective in Indian population.Results:Data were collected from 30 patients and they were divided into two groups, CTS <5 (15) and CTS ≥5 (15). High CTS ≥5 was statistically significantly associated with high incidence of pneumonia (P = 0.046), increased requirement of mechanical ventilation (P = 0.025) and mortality (P = 0.035) in chest trauma. Area under the ROC for mortality shows that the test is acceptable (0.75) and at CTS score 5.5 maximum sensitivity is 87.5% and specificity is 68%.Conclusion:This study concludes that a CTS ≥5 is associated with poor outcomes. This scoring system may be used to identify patients at risk of complications and institute early intensive focussed care.

Analysis of Injury Patterns and Outcomes of Blunt Thoracic Trauma in Elderly Patients

“…Around 31 (38.8%) patients had CTS score ≥ 5 and showed significant association with complications such as pneumonia (p = 0.014), ARDS (p = 0.014), an increased need for ventilation (p = 0.00), and mortality (p = 0.001). Similarly, Harde et al showed that CTS score > 5 is associated with poor outcomes and can be utilized for risk assessment in trauma patients to provide timely management [10].…”

“…Patients' information was recorded in a semi-structured questionnaire, which included their sociodemographic characteristics, mode of trauma, primary and associated diagnoses, severity of trauma, and outcomes. Severity of trauma was assessed using the Chest Trauma Scoring (CTS) system, as shown in Figure 1 [9,10].…”

Chest Trauma Score of Thoracic Trauma Patients in Dr. Mohammad Hoesin Palembang January-June 2020

“…Thoracic trauma accounts for 15-20% of all injuries, with mortality rates varying from 10% to 60%. 3 CTS is derived from several previously identified factors associated with poor outcome. 4 CTS includes 4 parameters including patient age (1-3 points), pulmonary contusions (0-3 points), the number of rib fractures (1-3 points), and bilateral rib fractures (2 points).…”

“…This score was first developed using a single institutional sample of 649 patients by Pressley et al and then validated in 1,361 patients at another single institution by Chen et al 4 Chen et al found that this simple score can predict the likelihood of adverse outcomes such as complications and mortality in thoracic trauma patients if CTS is ≥5. 3 Therefore, the authors decided to study the features of CTS in thoracic trauma patients in the Indonesian subpopulation, especially at our hospital.…”

The Relationship between Thoracic Trauma Scoring and Mortality in Blunt Thoracic Trauma Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

“…Thoracic trauma accounts for 15-20% of all injuries, with mortality rates ranging from 10% to 60%. [1][2][3][4] Based on the 2018 Riskesdas, the highest incidence of injuries in Indonesia occurred in the home environment (44.7%), roads (31.4%), and workplaces (9.1%). The percentage of chest trauma incidents is 2.6% in Indonesia and 3.0% in South Sumatra.…”