Aplikasi revised trauma score, injury severity score, dan trauma and injury severity score dalam memrediksi mortalitas pada pasien multitrauma di IRDB BLU RSUP Prof. Dr. R. D. Kandou Manado

Abstract

Trauma is the main cause of deaths among teenagers and young adults. Most of the cases are due to traffic accidents, therefore, a scoring system that can transforms the trauma quality to numbers is very valuable. This scoring system is needed to predict mortality, compare therapeutic methods, function as a triage tool pre hospitalization and during the way to the hospital, evaluate quality improvement and prevention program, and as a tool in trauma studies. There are several available scoring systems usually used in trauma studies, as follows: Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma Related Injury Severity Score (TRISS). This study aimed to obtain the easiest applicable scoring system to multitraumatic patients in Prof. Dr. R. D. Kandou Hospital Manado. This was an observational correlation study. Evaluation of mortality was done by using the scoring systems and then was compared to the results in the field. There were 37 multitraumatic patients consisted of 30 males and 7 females. Five patients died during this study. By using RTS, of score >7 there was 1 death; of score 6-7 there were 3 deaths; and of score-5 there was 1 death. By using ISS, all dead patients had score ≥25, meanwhile by using TRISS, 2 dead patients had score 81-100,1 dead patient had score 61-80, and 2 dead patients had score 41-60. Conclusion: RTS is the easiest applicable scoring system at triage and pre-hospitalization, and is recommended to be a part of management of multitraumatic patients. Along with ISS, RTS can be used as a mortality predictor among multitraumatic patients.Keywords: trauma, RTS, ISS, TRISS, mortalityAbstrak: Trauma merupakan penyebab kematian utama pada usia remaja dan dewasa muda. Sistim penilaian (skoring) yang dapat mengubah kualitas trauma ke dalam bentuk nilai diperlukan agar dapat meramalkan mortalitas, membandingkan metode terapi, merupakan alat triase pre- dan antar rumah sakit, menilai perbaikan kualitas dan program pencegahan, serta merupakan alat dalam studi trauma. Beberapa sistem skoring yang sering digunakan dalam penelitian ialah Revised Trauma Score (RTS), Injury Severity Score (ISS), dan Trauma Related Injury Severity Score (TRISS). Penelitian ini bertujuan untuk mendapatkan pilihan sistim skoring yang paling mudah diaplikasikan pada pasien multitrauma di BLU RSUP Prof. Dr. R. D. Kandou, Manado. Jenis penelitian ialah observasional korelatif. Penilaian ini mengaplikasikan masing-masing skor terhadap angka mortalitas dan dibandingkan dengan hasil yang diperoleh di lapangan. Dalam penelitian ini terdapat 37 pasien multitrauma, terdiri dari 30 laki-laki dan 7 perempuan. Jumlah pasien yang meninggal selama penelitian ialah 5 orang. Untuk RTS, dari pasien dengan skor >7 terdapat 1 kematian; dari pasien dengan skor 6-7 terdapat 3 kematian, dan dari pasien dengan skor 5 terdapat 1 kematian. Untuk ISS, semua pasien yang meninggal memiliki skor ≥25, sedangkan untuk TRISS, 2 pasien yang meninggal dengan skor 81-100, 1 pasien dengan skore 61-80, dan 2 pasien yang meninggal dengan skor 41-60. Simpulan: RTS paling mudah diaplikasikan saat triase dan fase pre rumah sakit, serta direkomendasikan untuk menjadi bagian dari pedoman penanganan kasus multitrauma. Bersama-sama dengan ISS, RTS dapat diaplikasikan sebagai prediktor mortalitas pasien multitrauma.Kata kunci: trauma, RTS, ISS, TRISS, mortalitas

Correlation Between Revised Trauma Score Output and Head Trauma Mortality

“…Based on the results of the normality test the P < 0.05 value was obtained which means the distribution was abnormal and using the Mann-Whitney alternative test obtained p value = 0.000> 0.05 which means there was a relationship between RTS and mortality of head trauma patients. RTS can also be used as an assessment as long as the patient is still in treatment but with periodic examinations, not just in one point of time RTS is the easiest score to use in the prehospital phase and field triage that can be done by doctors or paramedics in assessing the mortality of trauma patients [9]. In line with the results of this study, RTS has become a standard assessment in the ATLS protocol.…”

“…In line with the results of this study, RTS has become a standard assessment in the ATLS protocol. Physiological parameters (respiratory rate, systolic blood pressure, and GCS) can change at any time according to the severity of the injury and treatment provided, so that aside from being a scoring instrument in the prehospital or triage phase, RTS can also be used as an assessment as long as the patient is still in treatment but with periodic checks, not just in one point of time [9]. Based on the results of the normality test the P < 0.05 value was obtained which means the distribution was abnormal and using the Mann-Whitney alternative test obtained p value = 0.000> 0.05 which means there was a relationship between RTS and mortality of head trauma patients.…”

Scoring Trauma with Revised Trauma Score in Scoring Patient Motility with Traumatic Head Injury

“…Head traumatic triggers several selullar and molecular so it appear histochemical responses, molecular responses, dan genetic response that cause secondary insult, in ischemic and weighted the primary brain damage (4).…”

“…According to (4) research trauma is the biggest cause in teenager and younger. The scoring system that change the quality of trauma in the needed score in her research is Revised Trauma Score (RTS), Injury Severity Score (ISS), dan Trauma Related Injury SeverityScore (TRISS).…”

“…Head traumatic prevalency is enough high in the world, head traumatic around 5,1 million become 8,4 million and 150-170 Millian per 100 hthousand per person in a year. It around 50-60 million of new cases of traumatic in whole the world, The death of traumatic is 30-40% and 10% and the mortality has 5 Million in a year that caused million of people is disability because of the traumatic (4) .…”