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Journal Article

Citation

Yolcu S, Sener K, Tapsiz H, Ozer AI, Avci A. Ir. J. Med. Sci. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, General Publications)

DOI

10.1007/s11845-022-03208-2

PMID

36336767

Abstract

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.

AIM: 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).

CONCLUSION: In conclusion, RTS and CRAMS better predicted mortality in high-energy-trauma patients than EWS.


Language: en

Keywords

CRAMS; Early-Warning Score; Revised Trauma Score

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