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The role of the Revised Trauma Score in penetrating trauma
Steffany Barbosa Reis1, Matheus Portugal1, Maria Tavares1
1- Hospital do Subúrbio Salvador - Salvador - BA - Brasil.
Introduction:
The Revised Trauma Score (RTS) is one of the primary tools used to predict mortality in trauma patients. RTS is calculated at admission based on respiratory rate, systolic blood pressure, and Glasgow Coma Scale score. Its accuracy has been evaluated in several studies; however, most have predominantly included victims of blunt trauma, making its applicability to penetrating injuries a matter of ongoing debate.
Objective:
To compare the prognostic accuracy of the RTS for mortality prediction in patients with blunt trauma versus penetrating trauma.
Methods:
This retrospective cohort study included trauma patients treated at a referral hospital. The prognostic accuracy of the RTS for each trauma mechanism was assessed using receiver operating characteristic curves, and comparisons were performed using the DeLong test. Logistic regression analysis was conducted to identify additional independent predictors of trauma mortality. The chi-square test was used to determine a cutoff point for the RTS in penetrating trauma that would correspond to the reference cutoff adopted for blunt trauma.
Results:
A total of 3,575 patients were included. Of these, 2,448 (68.5%) sustained blunt trauma and 1,127 (31.5%) penetrating trauma. The area under the curve for mortality prediction was 0.813 in the blunt trauma group and 0.800 in the penetrating trauma group, with no statistically significant difference between them. Independent predictors of mortality included age, RTS value, acidosis, coagulopathy, and penetrating mechanism.
Conclusion:
The RTS is an accurate tool for predicting mortality in both blunt trauma and penetrating trauma.
