背景:创伤是急诊科(ED)介绍的常见原因之一。具体来说,严重创伤患者通常会出现致命的并发症,包括创伤性休克或呼吸或多器官衰竭/功能障碍,这些情况会导致高死亡率的风险。创伤患者分诊中的评分系统可以帮助确定损伤的严重程度和患者的预后。
目的:在本研究中,我们的目的是比较早期预警评分(EWS),修订创伤评分(RTS),和CRAMS预测高能创伤患者的损伤严重程度和预后。
方法:这项回顾性研究纳入了2020年4月1日至2020年9月31日在我们急诊科(ED)评估的成人高能量创伤患者(>18岁)。我们纳入了总共177名高能创伤患者的研究。我们比较了EWS、RTS和循环的有效性,呼吸,腹部,电机,和语音(CRAMS)预测死亡率。这项研究的主要结果是死亡率。
结果:我们的研究包括67名女性和110名男性,平均年龄为39.2岁。这些病人中,6人在ICU住院期间死亡,104人出院。RTS(AUC:0.978,CI:0.945-0.994,p<0.001)和CRAMS(AUC:0.978,CI:0.944-0.994,p<0.001)具有相同的AUC值,但EWS的AUC值(AUC:0.966,CI:0.927-0.987,p<0.001)较低。EWS的敏感性为93.1(CI:77.2-99.2%),RTS的敏感性为96.55(CI:82.2-99.9),CRAMS的敏感性为96.55%(CI:82.2-99.9)。RTS显示出最高的比重水平(96.62%,CI:92.3-98.9)。
结论:结论:RTS和CRAMS比EWS更好地预测高能创伤患者的死亡率。
BACKGROUND: Trauma is one of the common reasons for emergency department (ED) presentations. Specifically, severe-trauma patients often present with mortal complications, including traumatic shock or respiratory or multiorgan failure/dysfunction, and these situations cause high-mortality risk. Scoring systems in the triage of trauma patients can help determine the injury\'s severity and the patient\'s prognosis.
OBJECTIVE: In this study, we aimed to compare Early-Warning Score (EWS), Revised Trauma Score (RTS), and CRAMS to predict the severity and prognosis of damage among high-energy-trauma patients.
METHODS: This retrospective study included adult high-energy-trauma patients (> 18 years of age) assessed in our emergency department (ED) from April 1, 2020, to September 31, 2020. We included a total of 177 high-energy-trauma patients in the study. We compared the effectiveness of EWS; RTS; and circulation, respiration, abdomen, motor, and speech (CRAMS) in predicting mortality. The primary outcome of this study was mortality.
RESULTS: We included 67 females and 110 males with a mean age of 39.2 in our study. Of those patients, 6 died during ICU hospitalization and 104 were discharged from the ward. RTS (AUC: 0.978, CI: 0.945-0.994, p < 0.001) and CRAMS (AUC: 0.978, CI: 0.944-0.994, p < 0.001) had the same AUC values, but the AUC value of EWS (AUC: 0.966, CI: 0.927-0.987, p < 0.001) was lower. Sensitivity of EWS was 93.1 (CI: 77.2-99.2%), and sensitivity of RTS was 96.55 (CI: 82.2-99.9) and CRAMS\' sensivity was 96.55% (CI: 82.2-99.9). RTS showed the highest specivity level (96.62%, CI: 92.3-98.9).
CONCLUSIONS: In conclusion, RTS and CRAMS better predicted mortality in high-energy-trauma patients than EWS.