Injury Severity Scoring System for Trauma Patients and Trauma Outcomes Research in Korea

정, 경원; 이, 국종; 김, 지영

doi:10.17479/jacs.2016.6.1.11

Cited by 25 publications

(24 citation statements)

References 23 publications

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“…When a trauma patient visits the emergency room, regional trauma centers assign the injury severity score by considering the affected body region and the severity of each injury. Usually, severe trauma patients are those with a score of at least 15 points [4]. Another method to assess the severity of facial trauma is facial injury severity scale (FISS) ( Table 1).…”

Section: Archives Of Craniofacial Surgerymentioning

confidence: 99%

Trauma severity and mandibular fracture patterns in a regional trauma center

Lee

Kim

Choi

et al. 2020

Arch Craniofac Surg

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Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p < 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

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Section: Archives Of Craniofacial Surgerymentioning

confidence: 99%

Trauma severity and mandibular fracture patterns in a regional trauma center

Lee

Kim

Choi

et al. 2020

Arch Craniofac Surg

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“…The ISS and RTS are useful scoring systems for the assessing the severity of injury in trauma patients. However, these scores are difficult to use immediately in the ED [15,[18][19][20]. First, to calculate the ISS, we need anatomical information reflective of the severity of the full range of trauma after the final diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Outcomes Among Patients with Trauma in the Emergency Department: A Comparison with the Modified Early Warning Score, Revised Trauma Score, and Injury Severity Score

Kang

Song

et al. 2021

J Trauma Inj

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Purpose: To evaluate the severity of trauma, many scoring systems and predictive models have been presented. The quick Sequential Organ Failure Assessment (qSOFA) is a simple scoring system based on vital signs, and we expect it to be easier to apply to trauma patients than other trauma assessment tools. methods: This study was a cross-sectional study of trauma patients who visited the emergency department of Jeju National University Hospital. We excluded patients under the age of 18 years and unknown outcomes. We calculated the qSOFA, the Modified Early Warning Score (mEWS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) based on patients' initial vital signs and assessments performed in the emergency department (ED). The primary outcome was mortality within 14 days of trauma. We analyzed qSOFA scores using multivariate logistic regression analysis and compared the predictive accuracy of these scoring systems using the area under the receiver operating characteristic curve (AUROC). results: In total, 27,764 patients were analyzed. In the multivariate logistic regression analysis of the qSOFA, the adjusted odds ratios with 95% confidence interval (CI) for mortality relative to a qSOFA score of 0 were 27.82 (13.63-56.79) for a qSOFA score of 1, 373.31 (183.47-759.57) for a qSOFA score of 2, and 494.07 (143.75-1698.15) for a qSOFA score of 3. In the receiver operating characteristic (ROC) curve analysis for the qSOFA, mEWS, ISS, and RTS in predicting the outcomes, for mortality, the AUROC for the qSOFA (AUROC [95% CI]; 0.912 [0.871-0.952]) was significantly greater than those for the ISS (0.700 [0.608-0.793]) and RTS (0.160 [0.108-0.211]). Conclusions: The qSOFA was useful for predicting the prognosis of trauma patients evaluated in the ED.

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“…In Korea, the immature trauma system is an additional problem, as there is no training or legal requirements for paramedics to assess initial physiological parameters, such as the GCS or SBP of injured patients, and most hospitals do not even perform ISS measurements. Thus, the accuracy of pre-hospital vital signs or GCS values is limited and/or these measurements are frequently omitted [16][17][18]. In addition, because pre-hospital triage for injured patients has not been well-established in Korea, > 50% of patients who should have been admitted directly to a trauma center were actually transferred to our facility from another hospital [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…These issues make it extremely difficult to obtain accurate initial physiological data. In addition, ISS coding is only performed in 17 Korean trauma centers that were established after 2012, as time and resources are needed to train individuals to perform accurate coding [18]. Furthermore, the frequency of post-mortem examinations is much lower for Korean trauma cases than those in other countries [19,20], which further complicates AIS coding for patients who have died before or at their ER arrival.…”

Section: Discussionmentioning

confidence: 99%

Inclusion of lactate level measured upon emergency room arrival in trauma outcome prediction models improves mortality prediction: a retrospective, single-center study

Moon¹,

Hwang²,

Yoon³

et al. 2020

Acute Crit Care

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Background: This study aimed to develop a model for predicting trauma outcomes by adding arterial lactate levels measured upon emergency room (ER) arrival to existing trauma injury severity scoring systems. Methods: We examined blunt trauma cases that were admitted to our hospital during 2010-2014. Eligibility criteria were cases with an Injury Severity Score of ≥ 9, complete Trauma and Injury Severity Score (TRISS) variable data, and lactate levels that were assessed upon ER arrival. Survivor and non-survivor groups were compared and lactate-based prediction models were generated using logistic regression. We compared the predictive performances of traditional prediction models (Revised Trauma Score [RTS] and TRISS) and lactate-based models using the area under the curve (AUC) of receiver operating characteristic curves. Results: We included 829 patients, and the in-hospital mortality rate among these patients was 21.6%. The model that used lactate levels and age provided a significantly better AUC value than the RTS model. The model with lactate added to the TRISS variables provided the highest Youden J statistic, with 86.0% sensitivity and 70.8% specificity at a cutoff value of 0.15, as well as the highest predictive value, with a significantly higher AUC than the TRISS. Conclusions: These findings indicate that lactate testing upon ER arrival may help supplement or replace traditional physiological parameters to predict mortality outcomes among Korean trauma patients. Adding lactate levels also appears to improve the predictive abilities of existing trauma outcome prediction models.

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Injury Severity Scoring System for Trauma Patients and Trauma Outcomes Research in Korea

Cited by 25 publications

References 23 publications

Trauma severity and mandibular fracture patterns in a regional trauma center

Trauma severity and mandibular fracture patterns in a regional trauma center

Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Outcomes Among Patients with Trauma in the Emergency Department: A Comparison with the Modified Early Warning Score, Revised Trauma Score, and Injury Severity Score

Inclusion of lactate level measured upon emergency room arrival in trauma outcome prediction models improves mortality prediction: a retrospective, single-center study

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