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Correlation Between the Revised Physiological Trauma Score and CT Scan Results.

Maan Jamjoom1,2,3, Faisal A Boker1,2,3, Ahmad Wazzan1,2,3

  • 1Emergency Medicine, Ministry of the National Guard-Health Affairs, Jeddah, SAU.

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|September 23, 2024
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Summary

The Revised Physiological Trauma Score (rPTS) shows some correlation with CT findings in trauma patients. However, it cannot be reliably used to reduce unnecessary CT scans due to normal rPTS scores in patients with positive CT results.

Keywords:
clinical decision rulemajor traumamedical triagemultidetector computed tomographyprehospital trauma

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Area of Science:

  • Emergency Medicine
  • Radiology
  • Trauma Surgery

Background:

  • Trauma-scoring systems aid patient triage and clinical decisions.
  • Physiological trauma scores quantify injury severity, with few proven effective pre-clinically.
  • Clinical decision tools are needed to reduce unnecessary CT scans in trauma patients.

Purpose of the Study:

  • To investigate the correlation between the Revised Physiological Trauma Score (rPTS) and CT scan findings.
  • To determine if rPTS can be utilized to decrease the utilization of CT scans in trauma patients.

Main Methods:

  • Retrospective chart review of trauma patients who underwent pan-CT scans.
  • Analysis of 235 patients from the Emergency Department of King Abdulaziz Medical City, Jeddah (2008-2012).

Main Results:

  • A significant difference in mean rPTS was observed between negative and positive pan-CT scans (p=0.032).
  • Patients with rPTS <11 had a higher rate of positive CT scans (87%) compared to those with rPTS of 11 or 12 (74.1%) (p=0.044).
  • Notably, 72.7% of patients with a perfect rPTS score (12/12) still had positive pan-CT findings.

Conclusions:

  • While differences in abnormal CT scan frequencies exist, a significant number of patients with normal rPTS scores presented with abnormal CT findings.
  • The Revised Physiological Trauma Score (rPTS) is not sufficiently reliable to safely reduce the use of CT scans in trauma patient management.