Trauma Scores

Introduction: For more than 35 years, various scoring systems have been used as a method to assess the injury severity of multi-system trauma. They have been used as a tool for triage, for emergency-room quality management, for educational purposes, or nowadays, to evaluate the cost-effectiveness of either a complete hospital or a single department. This review provides the knowledge to score multi-system traumatized patients after their first treatment in the emergency room. It presents the advantages, disadvantages, and limitations of various trauma scores, including knowledge about the used parameters, the type of validation, the medical system in their country of origin, and, of course, their mathematical background. Relevant examples include physiological trauma scores (GCS, RTS, APACHE), anatomic and injury pattern-based scores (ISS, NISS, ICISS), biological aspects, and mixed scoring systems (PTS, TRISS, ASCOT). These scores are explained in detail and discussed in terms of their practicality.

Materials and Methods: The study, conducted from January 2006 to June 2006, was chosen to provide a comprehensive understanding of trauma scoring systems during this specific time frame. This study comprises 50 cases of all patients admitted and treated in the National Trauma Center, which is affiliated with the University Central Military Hospital.

Results: The distribution by sex is as follows: M, 74% (37); F, 26% (13). By age, the distribution is as follows: 0-15 years old, 12% (6), 15-55 years old, 66% (33), and over 55 years old, 22% (11). The Analysis of the data Value of AIS is variable from 3 to 27. The value of ISS ranges from 5 to 57. In this study, there is evidence that the value of RTS is variable from 3,274-7,841, that in general is in an indirect relationship with the value of ISS, that depending on trauma mechanism, the situation of the traumatic patient in coming by the hospital (BP; RF: GCS) and age of the patient is critical. The value of TRISS (Mortality) ranges from 0.4 to 97%. These results provide valuable insights into the practical application of trauma scoring systems in clinical practice, particularly in the context of multi-system trauma.

Conclusions: It is evident from this study that most traumatic patients have multiple injuries, and scoring systems have been used as a reliable method to assess the injury severity of multi-system trauma. They have consistently proven their value as a tool for triage, emergency-room quality management, educational purposes, and, nowadays, to evaluate the cost-effectiveness of a comprehensive hospital. This reaffirms the importance and reliability of trauma scoring systems in clinical practice.

Keywords: AIS, ISS, RTS, TRISS