RTS

RTS
  • 文章类型: Journal Article
    在2000年至2015年期间,由于加强了全球合作和增加了资金,在减轻全球疟疾负担方面取得了重大进展。然而,2015年后进展停滞不前,COVID-19大流行似乎扭转了其中的一些进展,需要对干预措施进行严格的重新评估。本文旨在分析这些挫折,并为撒哈拉以南非洲的疟疾控制和预防提供建议。
    我们在GoogleScholar上进行了搜索,PubMed,和相关组织网站,以确定2015年至今撒哈拉以南非洲疟疾控制和预防及相关挑战的相关研究。此外,对个别撒哈拉以南非洲国家的研究进行了审查,以确保全面性。使用叙事综合方法提取和分析来自选定研究的数据,以提供证据的简要概述。
    我们观察到,撒哈拉以南非洲地区疟疾控制进展的停滞与社会经济,政治,和环境因素。该地区人口爆炸加剧了这些挑战,由于资金短缺和危机不断,干预措施覆盖率低,以及现有疟疾商品功效的退化。
    撒哈拉以南非洲正处于抗击疟疾的十字路口。有希望的新领域,如疟疾疫苗,预防性单克隆抗体,新一代驱虫蚊帐,和潜在的人工智能驱动的技术为推进该地区的疟疾控制和预防提供了希望。通过承诺和合作,利用这些机会可以帮助克服挑战,并最终消除撒哈拉以南非洲的疟疾。
    UNASSIGNED: Between 2000 and 2015, significant gains were recorded in reducing the global burden of malaria due to enhanced global collaboration and increased funding. However, progress has stagnated post-2015, and the COVID-19 pandemic seems to have reversed some of these gains, necessitating a critical reevaluation of interventions. This paper aims to analyze the setbacks and offer recommendations for advancement in malaria control and prevention in sub-Saharan Africa.
    UNASSIGNED: We conducted searches on Google Scholar, PubMed, and relevant organization websites to identify relevant studies on malaria control and prevention and associated challenges in sub-Saharan Africa from 2015 to the present. Additionally, studies on individual sub-Saharan African countries were reviewed to ensure comprehensiveness. Data from selected studies were extracted and analyzed using a narrative synthesis approach to offer a concise overview of the evidence.
    UNASSIGNED: We observe that the halt in progress of malaria control in sub-Saharan Africa has deep roots in socioeconomic, political, and environmental factors. These challenges are exacerbated by the population explosion in the region, low coverage of interventions due to funding deficits and incessant crises, and the degradation of the efficacy of existing malaria commodities.
    UNASSIGNED: Sub-Saharan Africa is at a crossroads in its fight against malaria. Promising new frontiers such as malaria vaccines, preventive monoclonal antibodies, new-generation insecticide-treated nets, and potentially artificial intelligence-driven technologies offer hope in advancing malaria control and prevention in the region. Through commitment and collaboration, leveraging these opportunities can help surmount challenges and ultimately eliminate malaria in sub-Saharan Africa.
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  • 文章类型: Journal Article
    背景:在前交叉韧带重建后完成正式康复后,功能能力仅在一小部分受影响的个体中恢复。因此,正式康复的结束并不是功能康复的结束。
    目的:比较前交叉韧带(ACL)重建后后期康复计划与常规护理的依从性和有效性。
    方法:这种前瞻性,双盲,多中心,平行组,随机对照试验,包括正式康复完成后18至35岁的人(重建后平均[SD]241[92]天)。参与者被随机分组接受5个月的神经肌肉表现干预(Stop-X组)或常规护理(医学规定的标准物理治疗,个人正式康复,家庭练习)。所有结果均每月测量一次。主要结果是跳伞后着陆时恢复正常的膝盖分离距离。计算基线调整的线性混合模型。
    结果:总计,112名参与者(Stop-X:57;通常护理:55,)进行了分析。最初,Stop-X组的平均(SD)干预频率(单位/周)高于常规治疗组:第1组2.65(0.96)对2.48(1.14)单位/周,第2个月2.28(1.02)对2.14(1.31)单位/周.对于主要结果,没有发现组间*时间(*基线)差异。组间*时间效应在2个月时有利于Stop-X组(运动期间自我报告的膝盖问题较少,KOOS运动)(Stop-X的估计值=64.3,95%CI24.4-104.3),更有信心重返体育运动(ACL-RSI)(62.4,10.7-114.2),更少的疼痛相关的膝盖问题(KOOS-PAIN)(82.8,36.0-129.6),提高日常活动能力(KOOS-ADL)(71.1,6.4-135.7),改善了3个月和4个月前跳距离的肢体对称指数(0.34,0.10-0.57;0.31,0.08-0.54)。运动恐惧症没有发生组间*时间效应,症状相关的膝盖问题或平衡跳表现。在干预结束时,79%的Stop-X和70%的常规护理参与者(p<0.05)已成功恢复到受伤前的运动类型和水平。
    结论:作为ACL重建后后期康复的一部分,Stop-X干预略优于常规治疗。小的好处可能证明在正式康复完成后使用它是合理的。
    BACKGROUND: At the completion of formal rehabilitation after anterior cruciate ligament reconstruction, functional capacity is only restored in a small proportion of affected individuals. Therefore, the end of formal rehabilitation is not the end of functional rehabilitation.
    OBJECTIVE: To compare adherence to and effectiveness of a late-stage rehabilitation programme with usual care after anterior cruciate ligament (ACL) reconstruction.
    METHODS: This prospective, double-blind, multicentre, parallel group, randomised controlled trial, included people aged 18 to 35 years after formal rehabilitation completion (mean [SD] 241 [92] days post-reconstruction). Participants were block-randomised to a 5-month neuromuscular performance intervention (Stop-X group) or usual care (medically prescribed standard physiotherapy, individual formal rehabilitation, home-exercises). All outcomes were measured once/month. Primary outcome was the normalised knee separation distance on landing after drop jump. Baseline-adjusted linear mixed models were calculated.
    RESULTS: In total, 112 participants (Stop-X: 57; Usual care: 55,) were analysed. Initially, mean (SD) intervention frequency (units/week) was higher in the Stop-X than the Usual care group: 2.65 (0.96) versus 2.48 (1.14) units/week in the first and 2.28 (1.02) versus 2.14 (1.31) units/week in the second month. No between-group*time(*baseline)-differences were found for the primary outcome. Between-group*time-effects favoured the Stop-X-group at 2 months (fewer self-reported knee problems during sport, KOOS-SPORT) (estimate = 64.3, 95 % CI 24.4-104.3 for the Stop-X), more confidence to return to sport (ACL-RSI) (62.4, 10.7-114.2), fewer pain-associated knee problems (KOOS-PAIN) (82.8, 36.0-129.6), improved everyday activity abilities (KOOS-ADL) (71.1, 6.4-135.7), and improved limb symmetry index in the front hop for distance at 3 and 4 months (0.34, 0.10-0.57; 0.31, 0.08-0.54). No between-group*time-effects occurred for kinesiophobia, symptom-associated knee problems or balance hops performance. At the end of the intervention, 79 % of the Stop-X and 70 % of the Usual care participants (p < 0.05) had successfully returned to their pre-injury sport type and level.
    CONCLUSIONS: The Stop-X intervention was slightly superior to usual care as part of late-stage rehabilitation after ACL-reconstruction. The small benefit might justify its use after formal rehabilitation completion.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    COVID-19大流行重塑了各种临床疾病的流行病学,包括与社会政策密切相关的创伤。这项研究检查并比较了创伤死亡率患者的特征,以及他们最初的预后创伤评分,在大流行前和大流行时期。
    我们进行了一项回顾性观察研究,涉及2018年7月23日至2020年2月19日在1级创伤中心去世的患者。从2020年2月20日至2021年9月22日(大流行)。还进行了与两个时期中一年中相同月份的12个月相匹配的亚组分析。到达时死亡或在到达时立即死亡的患者被排除在数据分析之外。我们收集并分析了人口统计学和临床数据,采用缩写损伤评分(AIS),伤害严重程度评分(ISS),修订创伤评分(RTS),以及创伤和国际空间站(TRISS)来比较最初的预后。
    我们的研究涵盖了1128名患者,其中529人在大流行组中,599人在大流行组中。人口统计特征显示,两个时期的患者人数没有显着差异。在这两个时期,机动车事故仍然是主要的伤害机制。而平均国际空间站增加不明显(22.80vs.22.91,p=0.902),平均RTS下降(6.32vs.5.82),和TRISS增加(23.97%vs.28.93%)在大流行期间(p<0.05)。大流行期间住院时间减少(15.57vs.12.54天,p<0.05)。亚组分析显示ISS增加,降低RTS,大流行期间TRISS增加(p<0.05)。
    总而言之,虽然总体人口统计学和损伤机制几乎没有变化,大流行期间的创伤患者表现出较差的估计临床预后,特别是生理创伤评分。死亡率升高归因于患者的临床状况较差。
    UNASSIGNED: The COVID-19 pandemic has reshaped the epidemiology of various clinical conditions, including trauma which is closely tied to social policies. This study examines and compares the characteristics of trauma mortality patients, and their initial prognostic trauma scores, in the pre-pandemic and pandemic periods.
    UNASSIGNED: We conducted a retrospective observational study involving patients who passed away at a level 1 trauma center from July 23, 2018, to February 19, 2020 (prepandemic), and from February 20, 2020, to September 22, 2021 (pandemic). A subgroup analysis that matched 12 of the same months of the year in the two periods was also done. Patients who arrived deceased or passed away immediately upon arrival were excluded from data analysis. We collected and analyzed demographic and clinical data, employing the Abbreviated Injury Score (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and ISS (TRISS) to compare initial prognoses.
    UNASSIGNED: Our study encompassed 1128 patients, with 529 in the prepandemic group and 599 in the pandemic group. Demographic characteristics showed no significant differences in the number of patients in the two periods. Motor vehicle accidents remained the predominant injury mechanism in both periods. While the mean ISS increased insignificantly (22.80 vs. 22.91, p = 0.902), the mean RTS decreased (6.32 vs. 5.82), and TRISS increased (23.97% vs. 28.93%) during the pandemic (p < 0.05). Hospital length of stay decreased in the pandemic period (15.57 vs. 12.54 days, p < 0.05). Subgroup analysis revealed increased ISS, decreased RTS, and increased TRISS during the pandemic (p < 0.05).
    UNASSIGNED: In conclusion, while overall demographics and injury mechanisms remained virtually unchanged, trauma patients during the pandemic displayed worse estimated clinical prognoses, particularly in physiological trauma scores. The heightened mortality rate was attributed to poorer clinical conditions of patients.
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  • 文章类型: Journal Article
    基于样品多路复用的蛋白质组策略依赖于分级以提高蛋白质组覆盖率。串联质量标签(TMT)实验,例如,目前可以容纳多达18个样本的蛋白质跨越几个数量级,因此需要分级分离以实现合理的蛋白质组覆盖。这里,我们提出了一种简单而有效的肽分级分离策略,即在基于梯度的碱性pH反相(BPRP)分级分离之前,使用强阴离子交换(SAX)旋转柱对合并的TMT样品进行两步洗脱。我们通过TMTpro18-plex实验强调了我们的策略,该实验使用了9种不同的人类细胞系进行生物学重复。我们收集了三个数据集,一个仅使用BPRP分馏,每个SAX-分区的另外两个,然后是BPRP。这三个数据集量化了相似数量的蛋白质和肽,并且数据突出了SAX分区之间肽电荷和等电点分布的明显差异。组合的SAX分区数据集贡献了10%以上的蛋白质和20%以上的独特肽,这些肽不是通过单独的BPRP分级分离定量的。除了这种改进的分馏策略,我们提供了9种人类细胞系中超过11,000种蛋白质的相对丰度谱的在线资源,以及使用卵巢癌和胰腺癌细胞系的另外两个实验。
    Sample multiplexing-based proteomic strategies rely on fractionation to improve proteome coverage. Tandem mass tag (TMT) experiments, for example, can currently accommodate up to 18 samples with proteins spanning several orders of magnitude, thus necessitating fractionation to achieve reasonable proteome coverage. Here, we present a simple yet effective peptide fractionation strategy that partitions a pooled TMT sample with a two-step elution using a strong anion-exchange (SAX) spin column prior to gradient-based basic pH reversed-phase (BPRP) fractionation. We highlight our strategy with a TMTpro18-plex experiment using nine diverse human cell lines in biological duplicate. We collected three data sets, one using only BPRP fractionation and two others of each SAX-partition followed by BPRP. The three data sets quantified a similar number of proteins and peptides, and the data highlight noticeable differences in the distribution of peptide charge and isoelectric point between the SAX partitions. The combined SAX partition data set contributed 10% more proteins and 20% more unique peptides that were not quantified by BPRP fractionation alone. In addition to this improved fractionation strategy, we provide an online resource of relative abundance profiles for over 11,000 proteins across the nine human cell lines, as well as two additional experiments using ovarian and pancreatic cancer cell lines.
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  • 文章类型: Journal Article
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  • 文章类型: Multicenter Study
    距骨穹顶(OLTD)的骨软骨病最常见于恢复体育活动是主要问题的患者。目前已经区分了两种手术类型,骨髓刺激技术和镶嵌成形技术。表明需要进行骨髓刺激作为所需外科手术的病变的大小最近已经减小(<1cm)。因此,这项研究的主要目的是评估OLTD手术后恢复运动的情况。我们的假设是,距骨圆顶骨软骨病变的手术可以在大多数情况下恢复体育活动。
    方法:这项多中心前瞻性研究是在10个专门从事足踝手术的法国中心进行的。所有年龄在18至65岁的有症状的OLTD患者对彻底的药物治疗至少6个月耐药,为手术辩护,包括2018年6月至2019年9月。除了通常的人口统计数据,体育实践和水平(专业,竞争性,休闲)进行了术前系统调查。先前已根据病变的关节造影阶段建立了手术管理和术后随访的通用方案。根据大小的最新建议,还有深度,被考虑在内。主要终点是恢复运动。
    结果:在至少12个月时进行了AOFAS(美国骨科足踝协会)评分的最终功能评估。
    结果:在58名运动患者中,70.6%恢复运动(41/58),平均延迟4.3个月。高AOFAS功能评分(p=0.02)和1期病变(p=0.006)是唯一与恢复运动显着相关的术前标准。没有其他因素可以预测重返体育运动。
    结论:我们的前瞻性研究表明,根据手术方案和标准化随访,70.6%的运动患者在OLTD手术后恢复运动。
    方法:II.
    BACKGROUND: Osteochondral lesions of the talar dome (OLTD) are most often found in patients for whom the return to sports activities is the main issue. Two types of surgery have been distinguished at present, bone marrow stimulation techniques and mosaicplasty techniques. The size of the lesion indicating the need for bone marrow stimulation as the required surgical procedure has recently been decreased (<1cm). The main objective of this study was therefore to evaluate the return to sport after OLTD surgery. Our hypothesis is that surgery of osteochondral lesions of the talar dome allows the resumption of sports activities in the majority of cases.
    METHODS: This multicenter prospective study was conducted across 10 French centers specializing in foot and ankle surgery. All patients aged 18 to 65 with symptomatic OLTD resistant to thorough medical treatment for at least 6 months, justifying surgery, were included from June 2018 to September 2019. In addition to the usual demographic data, the practice of sport and level (professional, competitive, leisure) were systematically investigated preoperatively. A common protocol for surgical management and postoperative follow-up had previously been established according to the arthrographic stage of the lesion. The most recent recommendations based on size, but also depth, were taken into account. The primary endpoint was return to sport.
    RESULTS: A final functional evaluation with the AOFAS (American Orthopedic Foot & Ankle Society) score was performed at a minimum of 12 months. Of 58 sports patients, 70.6% returned to sport (41/58) with an average delay of 4.3 months. A high AOFAS functional score (p=0.02) and a stage 1 lesion (p=0.006) were the only preoperative criteria significantly associated with a return to sport. No other factor was predictive of a return to sport.
    CONCLUSIONS: Our prospective study shows that 70.6% of sports patients returned to sport after OLTD surgery according to a surgical protocol and standardized follow-up.
    METHODS: II.
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  • 文章类型: Journal Article
    背景:在这项研究中,我们使用解剖评分系统缩写损伤量表(AIS)来计算损伤严重程度评分(ISS)和患者到达时修订创伤评分(RTS)的生理评分系统.两个评分均用于计算创伤和损伤严重程度评分(TRISS),以预测创伤情况下的患者预后。
    方法:这种前瞻性,横截面,观察性研究是在三级护理机构的创伤中心进行的,包括两种性别的患者,年龄≥18岁,ISS≥15。共评估了18个月期间的2084例创伤,研究了96例符合纳入标准的钝性创伤。
    结果:道路交通事故中受伤的患者构成了最大的病例数。在96例ISS≥15的患者中,有77例在治疗期间死亡,19例存活。ISS范围为15至66,平均±SD评分为27.48±8.79。非幸存者的ISS显著高于幸存者(p<0.001)。RTS范围为<1至7.84,平均±SD评分为4.52±2.08。与幸存者相比,非幸存者的RTS较低(RTS<5,n=52),差异有统计学意义(p<0.001)。平均±SDTRISS(Ps)评分为0.69±2.288。在非幸存者(NS)组中,15例患者的TRISS(Ps)在0.26-0.50之间,其次是0.51-0.75(n=18),0.76-0.90(n=12),和0.90-0.95(n=11)。尽管16名幸存者的TRISS(Ps)在0.96和1之间,但发现TRISS与患者预后之间存在统计学上的显着关联(p值<0.001)。对接收机工作特性(ROC)曲线进行分析,发现TRISS(94.7%)和RTS的灵敏度相当(94.7%),而ISS对预测患者结局的敏感性较低(36.8%)。RTS(79.2%)和TRISS(76.6%)评分比ISS(5.2%)更具特异性。
    结论:TRISS评分对创伤患者的治疗很有用,因为它可以令人满意地预测创伤患者的死亡率。创伤评分对于确定法医学案件中的伤害性质具有巨大帮助。
    BACKGROUND: In this study, we used the anatomic scoring system Abbreviated Injury Scale (AIS) to calculate the Injury Severity Score (ISS) and the physiological scoring system for the Revised Trauma Score (RTS) on the arrival of patients. Both scores were used to calculate the Trauma and Injury Severity Score (TRISS) for predicting the patient outcome in a case of trauma.
    METHODS: This prospective, cross-sectional, observational study was carried out at the trauma centre of a tertiary care institute and included patients of either sex, age ≥18 years, and ISS ≥15. A total of 2084 cases of trauma over a period of 18 months were assessed, and 96 cases of blunt trauma meeting the inclusion criteria were studied.
    RESULTS: Patients injured in road traffic accidents constituted the maximum caseload. Out of a sample size of 96 patients with ISS ≥15, 77 died during the treatment and 19 survived. The ISS ranged from 15 to 66, with a mean ± SD score of 27.48 ± 8.79. Non-survivors had a statistically higher significant ISS than survivors (p<0.001). The RTS ranged from <1 to 7.84, with a mean ± SD score of 4.52 ± 2.08. Non-survivors had low RTS (RTS <5, n=52) compared to survivors, and the difference was statistically significant (p<0.001). The mean ± SD TRISS (Ps) score was 0.69 ± 2.288. In the non-survivor (NS) group, 15 patients had TRISS (Ps) between 0.26-0.50, followed by 0.51-0.75 (n=18), 0.76-0.90 (n=12), and 0.90-0.95 (n=11). While 16 survivors had TRISS (Ps) between 0.96 and 1, a statistically significant association was found between TRISS and patient outcome (p-value <0.001). On the receiver operating characteristic (ROC) curve analysis, the sensitivity of TRISS (94.7%) and RTS was found to be comparable (94.7%), whereas ISS was less sensitive (36.8%) in predicting the patient outcome. RTS (79.2%) and TRISS (76.6%) scores were more specific than ISS (5.2%) for outcome analysis.
    CONCLUSIONS: The TRISS score is useful in the management of trauma patients as it can satisfactorily predict mortality in a case of trauma. The trauma scores are of immense help in determining the nature of injury in medicolegal cases.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    背景:在急诊科(ED)确保对创伤性脑损伤(TBI)患者的快速和精确的死亡率预测对于患者分诊和提高预后至关重要。我们的目的是估计和比较年龄创伤评级指数的预测能力,格拉斯哥昏迷量表,呼吸频率,收缩压评分(TRIAGES)和修订后的创伤评分(RTS)对孤立性TBI患者24小时住院死亡率的影响。
    方法:我们进行了一项回顾性单中心研究,分析了2020年1月1日至2020年12月31日在南通大学附属医院急诊室接受治疗的1156例孤立性急性TBI患者的临床资料。我们计算了每个患者的TRIAGES和RTS评分,并使用受试者工作特征(ROC)曲线估计了其短期死亡率的预测值。
    结果:87例患者(7.53%)在入院24小时内死亡。非存活组比存活组有更高的TRIAGES和更低的RTS。与非幸存者相比,幸存者的格拉斯哥昏迷量表评分(GCS)较高,中位评分为15分(12,15分),中位评分为4.0分(3.0,6.0分).TRIAGES的粗比值比和调整后比值比(ORs)分别为1.79,95%CI(1.62至1.98)和1.79,95%CI(1.60至2.00),分别。RTS的粗OR和调整OR分别为0.39,95%CI(0.33至0.45)和0.40,95%CI(0.34至0.47),分别。TRIAGES的ROC(AUROC)曲线下面积,RTS,GCS为0.865(0.844至0.884),0.863(0.842至0.882),和0.869(0.830至0.909),分别。对于TRIAGES,预测24小时住院死亡率的最佳临界值为3,对于RTS6.08,8为GCS。亚组分析显示,在65岁及以上的患者中,TRIAGES(0.845)的AUROC高于GCS(0.836)和RTS(0.829),尽管差异无统计学意义。
    结论:TRIAGES和RTS在预测孤立性TBI患者的24小时住院死亡率方面显示出良好的疗效,具有与GCS相当的性能。然而,提高评估的全面性并不一定转化为预测能力的整体提高。
    Ensuring rapid and precise mortality prediction in patients with traumatic brain injury (TBI) at the emergency department (ED) is paramount in patient triage and enhancing their outcomes. We aimed to estimate and compare the predictive power of the Trauma Rating Index in Age, Glasgow Coma Scale, Respiratory rate, and Systolic blood pressure score (TRIAGES) and Revised Trauma Score (RTS) for 24-h in-hospital mortality in patients with isolated TBI.
    We conducted a retrospective single-center study analyzing clinical data from 1156 patients with isolated acute TBI treated in the ED of the Affiliated Hospital of Nantong University from January 1, 2020, to December 31, 2020. We calculated each patient\'s TRIAGES and RTS scores and estimated their predictive value for short-term mortality using receiver operating characteristic (ROC) curves.
    87 patients (7.53%) died within 24 h of admission. The non-survival group had higher TRIAGES and lower RTS than the survival group. Compared to non-survivors, survivors exhibited higher Glasgow Coma Scale scores (GCS) with a median score of 15 (12, 15) compared to a median score of 4.0 (3.0, 6.0). The crude and adjusted odds ratios (ORs) for TRIAGES were 1.79, 95% CI (1.62 to 1.98) and 1.79, 95% CI (1.60 to 2.00), respectively. The crude and adjusted ORs for RTS were 0.39, 95% CI (0.33 to 0.45) and 0.40, 95% CI (0.34 to 0.47), respectively. The area under the ROC (AUROC) curve of TRIAGES, RTS, and GCS was 0.865 (0.844 to 0.884), 0.863 (0.842 to 0.882), and 0.869 (0.830 to 0.909), respectively. The optimal cut-off values for predicting 24-h in-hospital mortality were 3 for TRIAGES, 6.08 for RTS, and 8 for GCS. The subgroup analysis showed a higher AUROC in TRIAGES (0.845) compared to GCS (0.836) and RTS (0.829) among patients aged 65 and above, although the difference was not statistically significant.
    TRIAGES and RTS have shown promising efficacy in predicting 24-h in-hospital mortality in patients with isolated TBI, with comparable performance to GCS. However, improving the comprehensiveness of assessment does not necessarily translate into an overall increase in predictive ability.
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