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Prediction of Mortality and Outcome of Various Trauma Scores in Polytrauma Patients
Ram C Besra1, Samir Toppo1, Pankaj Bodra1
1General Surgery, Rajendra Institute of Medical Sciences, Ranchi, IND.
Insights
The Trauma Revised Injury Severity Score (TRISS) is the most effective tool for predicting mortality in chest and abdominal trauma patients. Other trauma scoring systems also show statistical significance in predicting outcomes.
Area of Science:
- Trauma care
- Surgical outcomes
- Injury severity assessment
Background:
- Trauma is a leading cause of death in developing nations, with increasing prevalence.
- Effective trauma scoring systems are crucial for predicting mortality and prognosis.
- Chest and abdominal injuries are common and require accurate prognostic tools.
Purpose of the Study:
- To evaluate the prognostic accuracy of various trauma scoring systems.
- To assess mortality and morbidity prediction for chest and abdominal trauma.
- To identify the most effective scoring system for surgical patients.
Main Methods:
- Prospective observational study of 204 adult patients with chest and abdominal trauma.
- Initial resuscitation and comprehensive clinical/radiological evaluations (X-ray, USG, CT).
- Calculation and analysis of Revised Trauma Score (RTS), TRISS, NISS, and ISS.
Main Results:
- Male patients (85.3%) and the 21-30 age group (28%) were most affected.
- Automobile accidents (50%) and blunt injuries (83.8%) were the primary causes.
- TRISS and NISS demonstrated the highest statistical significance (p < 0.0001) in predicting mortality.
Conclusions:
- The Trauma Revised Injury Severity Score (TRISS) is the most precise method for grading chest and abdominal injuries.
- All evaluated trauma scoring systems are significant predictors of patient outcomes.
- TRISS aids surgeons in informed treatment decisions and outcome prediction.
Abstract:
Background In developing nations, the primary cause of death is trauma, and the prevalence of trauma is increasing as more vehicles are driven. Numerous trauma scoring systems have been created in order to predict the mortality rate and patients with trauma's prognosis. The purpose of the current study was to assess the prognostic ability of various trauma scoring systems for patients' mortality and morbidity in cases involving chest and abdominal injuries, as they are common in the surgery department. Methodology At Ranchi, Jharkhand's Rajendra Institute of Medical Sciences, a prospective observational study was conducted from June 2021 to September 2022. All patients who met the requirements for inclusion were older than 18 and reported chest and abdominal trauma totaling 204. Before any essential therapies, primary care and resuscitation, including airway maintenance, breathing, circulation, and hemorrhage control, were established. A comprehensive clinical evaluation was done based on each patient's needs. Radiological evaluation included chest X-ray and ultrasonography (USG) for chest trauma, whereas USG (FAST) and CT scans were for abdominal trauma. Trauma scores, such as the Revised Trauma Score (RTS), the Trauma Revised Injury Severity Score (TRISS), the New Injury Severity Score (NISS), and the Injury Severity Score (ISS), were computed and examined using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Results Of the 204 patients, 14.7% were female and 85.3% were male. The age range of 21-30 years old accounted for the largest percentage of cases (28%). 50 percent of injuries were caused by automobile accidents, while 25% were the result of assaults. At 83.8% versus 16.2%, blunt injuries were substantially more common than penetrating ones. In comparison to the chest, the abdomen was more frequently involved. The study's findings demonstrated that, while every trauma scoring was statistically significant in predicting mortality, the New Injury Severity Score (NISS), as well as the Trauma Revised Injury Severity Score (TRISS), became the most effective in predicting mortality (p < 0.0001). Conclusion According to the results, the most precise trauma grading method for chest and abdominal injuries is the Trauma Revised Injury Severity Score (TRISS), even though all other trauma scoring systems are useful in predicting patient outcomes. Surgeons using these metrics to predict outcomes and make well-informed treatment decisions can benefit greatly.

