The Relationship Between Trauma Scoring Systems and Outcomes in Patients With Severe Traumatic Brain Injury

Area of Science:

• Neuroscience
• Trauma Surgery
• Critical Care Medicine

Background:

• Severe traumatic brain injury (TBI) presents significant challenges in predicting patient outcomes.
• Accurate prognostication is crucial for guiding clinical management and resource allocation.

Purpose of the Study:

• To investigate the relationship between established trauma scoring systems and patient outcomes in severe TBI.
• To evaluate the predictive utility of the Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) for TBI prognosis.

Main Methods:

• Retrospective analysis of 697 severe TBI patients from the Korean Neuro-Trauma Data Bank System (January 2018 - June 2021).
• Patients were categorized based on Glasgow Outcome Scale-Extended (GOS-E) scores into unfavorable and favorable outcome groups.
• Evaluation of AIS head score, ISS, RTS, and TRISS in relation to patient outcomes and survival.

Main Results:

• Higher AIS head scores and ISS were significantly associated with unfavorable outcomes (p<0.001 and p=0.001, respectively).
• Higher RTS and TRISS scores correlated with favorable outcomes (p<0.001 for both).
• ISS was lower in survivors, while RTS and TRISS were higher in the survival group (p=0.036, p<0.001, p<0.001, respectively).

Conclusions:

• Trauma scoring systems (ISS, RTS, TRISS) are valuable tools for quantifying risk and predicting prognosis in severe TBI.
• TRISS demonstrated clinical utility as an indicator of predicted survival rate, effectively distinguishing between favorable and unfavorable outcomes.