Trauma Scoring Systems Explained

Abstract

Abstracts: 11th World Congress, Osaka, Japan S79 with 42 femoral and 11 tibial fractures were treated with either reamed intramedullary nailing (Group R, n = 28) or with unreamed nailing (Group NR, n = 20) within three days of their injuries. The mean value for age was 27.4 years (range, 16 to 63 years). In Group R, 28 femoral and four tibial fractures, reaming was performed up to 12.5 mm, and a 9-11 mm nail was inserted. In Group NR, 14 femur and 7 tibial fractures, a 9-10 mm nail was inserted without reaming. BAL was performed within 24 hours postoperatively with the standard procedure, in which sterile normal solution is instilled in 20 mL aliquots for a total of 100 ml, and immediately aspirated manually with a syringe. The cells contained in the lavage fluid were counted on uncentrifuged specimens by using a hemocytometer. The fluid then was centrifuged (1,500 rpm, 5 minutes), and differential cell counts were performed on a preparation that was stained with Wright-Giemsa stain. The percentage of lavage cells containing red or brown-red fat droplets (lipidladen cells) was calculated after examination of at least 200 cells on the slides stained with Sudan III, and the findings for two groups were compared. Results: The average age, ISS, and fracture index (Fl) were 28.1 ±12.4 years, 15.2 ±9.3, and 5.4 ±2.4 in Group R; and 26.3 ±11.7 years, 14.5 ±6.4, and 4.7±3.2 in Group NR, respectively. There were no significant differences between two groups. The mean percentage of lipid-laden cells in BAL fluid was 33.6 ±25.8% (range, 2 -89%) for Group R and 36.6 ±21.3 % (range, 2-70%) in Group NR. This difference also was not significant statistically. In this study, no typical features of fat embolism syndrome were identified in any of the patients.

The prognostic importance of serum IL-1β, IL-6, IL-8 and TNF-α levels compared to trauma scoring systems for early mortality in children with blunt trauma

“…For instance, the term ''obtunded'', when used to describe a child, could be interpreted in a number of ways. Such vagueness lends itself to misinterpretation and inaccurate scoring [18,32]. Our univariate statistical analysis showed that the relation between PTS and mortality was not significant.…”

“…Some of the previously published papers also showed increased levels of TNF-a and IL-1b early following injury [8,10,23,24]. The PTS, which is a simple and quick anatomic and physiologic scoring system, is the only one designed specifically to be applied to children, and reported to be developed to predict the survival of injured children [18,29]. Several reports have shown the validity of PTS to predict the severity of injury in those children in the most immediate danger of mortality [30,31].…”

“…Several reports have shown the validity of PTS to predict the severity of injury in those children in the most immediate danger of mortality [30,31]. However, critics have also pointed out that the PTS suffers from scoring vagueness [18,32]. For instance, the term ''obtunded'', when used to describe a child, could be interpreted in a number of ways.…”

“…A higher score on the PTS indicates a less injured patient. Patients scoring 8 or below are optimally treated at a level 1 pediatric trauma unit [18]. The relationship between overall mortality and the abovementioned prognostic risk factors was also analyzed.…”

Road traffic injuries in the elderly

“…Additionally, patient age is included for a more precise assessment of the probability of survival (Ps). 11 The coefficients were derived from the North American Major Trauma Outcome Study 1995.…”