The thorax trauma severity score and the trauma and injury severity score

Moon, Seong Ho; Kim, Jong Woo; Byun, Joung Hun; Kim, Sung Hwan; Choi, Jun Young; Jang, Inseok; Lee, Chung Eun; Yang, Jun; Kang, Dong Hun; Kim, Ki Nyun; Park, Hyun Oh

doi:10.1097/md.0000000000008317

Cited by 17 publications

(5 citation statements)

References 16 publications

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“…Calculating the TRISS, eighty-seven of the patients had a probability of survival above 90%, similar to the results of Carrapateira et al, who found that 85,2% of the patients studied had a probability of survival between 98 and 99% [27] . In the Intensive Care Unit in Gyeongsang, Korea, Moon et al evaluated 228 patients and obtained a lower probability of survival than our study, a median of 49,4%, ranging from 24,5 to 75,5%, but only included severe patients with ISS > 18 [29] .…”

Section: Discussioncontrasting

confidence: 63%

Probability of Survival in Thoracic Trauma: Comparative Analysis of 100 Patients Attended in a Reference Hospital at Aracaju/SE

Gonçalves,

Rezende,

Urquieta

et al. 2023

ijirms

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Background: Trauma is an injury characterized by structural alterations or physiological imbalance, resulting from acute exposure to some form of energy. Annually, about 5.8 million people die from trauma in the world. In Brazil, around 484,917 people died from external causes in 2016. Among the types of trauma, thoracic trauma is an important cause of death, existing multiple pathologies and association with avoidable causes of death if there were adequate care. Trauma scores have been developed and revised over the years to predict the likelihood of survival for these patients and guide healthcare teams' strategies. Methods: observational, prospective, quantitative study of victims of thoracic trauma who were admitted to Hospital João Alves Filho in Sergipe, based on the collection of clinical and demographic data. Results: from the sample of 100 patients, the mean age was 39.32 years, with 85.0% being male. 53% were diagnosed with blunt trauma, of which 33% were victims of traffic accidents; 47% penetrating trauma, being 26% by cold weapons and 21% by firearms. The average survival of these patients was 93.2%. Concomitant lesions were observed in 62.0% of the cases, 45% in the extremities and 45% in the head and neck. Conclusion: the profile of trauma victims were men between 20 and 39 years old, due to blunt trauma caused by a car accident, with a high probability of survival and associated injuries in other body segments.

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Section: Discussioncontrasting

confidence: 63%

Probability of Survival in Thoracic Trauma: Comparative Analysis of 100 Patients Attended in a Reference Hospital at Aracaju/SE

Gonçalves,

Rezende,

Urquieta

et al. 2023

ijirms

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“…Related studies have discovered major associated injuries and worse categories of injury severity scores as some of the determinants of mortality in chest injury. 2,10,13,18 Management followed the set protocols with additional infection prevention control guidelines re-amplified during the COVID-19 era. Pre-administration of the checklist for COVID-19 triage often resulted in suspiciously high score in many of our patients who presented with low values of peripheral arterial oxygen saturation (SpO2).…”

Section: Discussionmentioning

confidence: 99%

Profile Of Chest Injury in the Peri-COVID-19 Period: A Single Centre Series

Singh¹,

Rathore²,

Babu³

et al. 2023

IHRJ

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BACKGROUND: Chest traumas continue to constitute about 30% of all traumas and contribute to 25-50% of trauma-related deaths. COVID-19 has its primary pathophysiologies in the lung, and can worsen the morbidity and mortality of chest trauma if it occurs concomitantly. AIM: To Examine the profile and outcome of chest trauma across the peri-COVID-19 period. MATERIALS AND METHOD: A retrospective analysis of cases of chest trauma in the peri-COVID-19 period (mid-Nov 2019 to mid-March 2022) at GMC Doda. RESULTS: Eighty-five cases of chest trauma met inclusion criteria within the 28 months period, M:F = 7.5:1, age range 3-80years, mean age (38.60±17.40years) and median age of 37years. There were 54 (63.5%0) cases of blunt chest trauma and 31 (36.5%) cases of penetrating chest trauma. Thirty-one (36.5%) patients sustained haemothorax, 9 (10.6%) pneumothorax, 14 (16.5%) haemopneumothorax, 21 (24.7%) rib fractures, and 10 (11.8%) chest wall lacerations. Fifty-one (60%) patients had isolated chest trauma while the remaining 34 (40%) had associated injuries in one or more other organ systems. Closed thoracostomy tube drainage was definitive treatment in 48 (56.5%) patients while emergency thoracotomy was done in 5 (6%) patients. The treatment administered in the remaining 32 (37%) patients included intercostal nerve block for chest pain from rib fractures, wound exploration and wound repair. In the series, 75 (88%) had complete recovery, six (7%) patients left against medical advice, and four (5%) in-hospital mortality was recorded. CONCLUSION: The profile of chest trauma in the peri-COVID-19 period in our centre differed from the pre-COVID-19 years with a higher mortality figure. Management protocol also necessitated certain modifications.

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“…Although useful, the TTSS is limited in that it was designed for use in patients of advanced age, and follow-up studies have challenged its ability to predict mortality. 22 Arguably, the most widely used scoring system in recent literature is the RibScore, described by Chapman et al 11 Chapman incorporated specific anatomical factors in the RibScore to effectively predict adverse pulmonary outcomes. Although revolutionary in its ability to standardize the assessment of fracture severity and prognostication for trauma patients, this scoring system only evaluates patients at the time of admission and relies solely on radiographic findings with no evaluation of patient physiology.…”

Section: Discussionmentioning

confidence: 99%

“…The TTSS was among the first scoring systems developed that did not solely focus on the number of rib fractures present. Although useful, the TTSS is limited in that it was designed for use in patients of advanced age, and follow-up studies have challenged its ability to predict mortality 22 . Arguably, the most widely used scoring system in recent literature is the RibScore, described by Chapman et al 11 Chapman incorporated specific anatomical factors in the RibScore to effectively predict adverse pulmonary outcomes.…”

Section: Discussionmentioning

confidence: 99%

A clinical practice guideline using percentage of predicted forced vital capacity improves resource allocation for rib fracture patients

Billings

Khan

Clement

et al. 2021

J Trauma Acute Care Surg

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BACKGROUND:Predicting rib fracture patients that will require higher-level care is a challenge during patient triage. Percentage of predicted forced vital capacity (FVC%) incorporates patient-specific factors to customize the measurements to each patient. A single institution transitioned from a clinical practice guideline (CPG) using absolute forced vital capacity (FVC) to one using FVC% to improve triage of rib fracture patients. This study compares the outcomes of patients before and after the CPG change. METHODS:A review of rib fracture patients was performed over a 3-year retrospective period (RETRO) and 1-year prospective period (PRO). RETRO patients were triaged by absolute FVC. Percentage of predicted FVC was used to triage PRO patients. Demographics, mechanism, Injury Severity Score, chest Abbreviated Injury Scale score, number of rib fractures, tube thoracostomy, intubation, admission to intensive care unit (ICU), transfer to ICU, hospital length of stay (LOS), ICU LOS, and mortality data were compared. A multivariable model was constructed to perform adjusted analysis for LOS. RESULTS: There were 588 patients eligible for the study, with 269 RETRO and 319 PRO patients. No significant differences in age, gender, or injury details were identified. Fewer tube thoracostomy were performed in PRO patients. Rates of intubation, admission to ICU, and mortality were similar. The PRO cohort had fewer ICU transfers and shorter LOS and ICU LOS. Multivariable logistic regression identified a 78% reduction in odds of ICU transfer among PRO patients. Adjusted analysis with multiple linear regression showed LOS was decreased 1.28 days by being a PRO patient in the study (B = −1.44; p < 0.001) with R2 = 0.198. CONCLUSION:Percentage of predicted FVC better stratified rib fracture patients leading to a decrease in transfers to the ICU, ICU LOS, and hospital LOS. By incorporating patient-specific factors into the triage decision, the new CPG optimized triage and decreased resource utilization over the study period.

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The thorax trauma severity score and the trauma and injury severity score

Cited by 17 publications

References 16 publications

Probability of Survival in Thoracic Trauma: Comparative Analysis of 100 Patients Attended in a Reference Hospital at Aracaju/SE

Probability of Survival in Thoracic Trauma: Comparative Analysis of 100 Patients Attended in a Reference Hospital at Aracaju/SE

Profile Of Chest Injury in the Peri-COVID-19 Period: A Single Centre Series

A clinical practice guideline using percentage of predicted forced vital capacity improves resource allocation for rib fracture patients

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