TY  - JOUR
PY  - 2008//
TI  - Triage Revised Trauma Score change between first assessment and arrival at the hospital to predict mortality
JO  - International journal of emergency medicine
A1  - Lichtveld, R. A.
A1  - Spijkers, Anique T. E.
A1  - Hoogendoorn, J. M.
A1  - Panhuizen, I. F.
A1  - Van der Werken, C.
SP  - 21
EP  - 26
VL  - 1
IS  - 1
N2  - OBJECTIVE: To assess among seriously injured accident victims whether change of the Triage Revised Trauma Score (T-RTS) between first assessment and arrival at the hospital independently predicts mortality. DESIGN: Prospective cohort study. METHODS: The study analysed data on 507 trauma patients with multiple injuries and with a Hospital Trauma Index-Injury Severity Score (HTI-ISS) of 16 or higher, who were presented directly by ambulance services to the Accident & Emergency Department of the University Medical Centre Utrecht (the Netherlands) in 1999 and 2000. RESULTS: Compared to non-intubated patients whose T-RTS remained unchanged (reference category), the mortality risk was 3.1 times higher [95% confidence interval (CI): 1.5-6.3, p = 0.001] for patients with deteriorating T-RTS, 2.9 times higher (95% CI: 1.3-6.5, p < 0.001) for patients who had an initially good T-RTS but were nevertheless intubated and 5.7 times higher (95% CI: 3.6-9.0, p < 0.001) for patients who had an initially poor T-RTS and were intubated. These associations were independent of factors that could be assumed to have a direct effect on T-RTS, that is intravenous therapy, oxygen administration and being attended to by a mobile medical team at the scene of the accident. Along with T-RTS change, more advanced age was associated with a higher mortality risk. CONCLUSION: Intubation and a deteriorating T-RTS between the time of the accident and patient's arrival at the hospital are powerful independent predictors of mortality after hospitalisation. Together with advanced age, a deteriorating T-RTS should be the main aspect guiding the preclinical procedures.<p />  <p>Language: en</p>
LA  - en
SN  - 1865-1372
UR  - http://dx.doi.org/10.1007/s12245-008-0013-7
ID  - ref1
ER  -