The clinical application of new trauma scoring method in predicting patients' fatality rate in department of emergency

Abstract

Objective To investigate the accuracy of the new trauma scoring method: Glasgow coma score (GCS), age and systolic pressure score (GAP), in diagnosing patients' traumatic condition and predicting fatality rate in department of emergency. Methods The clinical data of 27 706 traumatic patients in department of emergency were collected. The observation was categorized into three kinds: death within 24 h after reaching department of emergency (24 h death); death from 24 h after reaching department of emergency to 7 d (death after 24 h); survival. On the basis of the trauma mechanism, GCS, age and systolic pressure score (MGAP), the GAP method was used for judging traumatic condition and predicting fatality rate of traumatic patients in department of emergency. The accuracy of GAP in predicting fatality rate was compared with revised trauma score (RTS), trauma and injury severity score (TRISS) and MGAP. The C-statistics method was used to calculate the accuracy in predicted the fatality rate. Results The C values (0.936 and 0.961) of GAP in predicting fatality rate after 24 h and in 24 h were higher than RTS (0.917 and 0.958) and MGAP (0.920 and 0.950), but slightly lower than TRISS (0.950 and 0.970). The traumatic condition in GAP was defined in this way: severity 3-10 scores, moderation 11-18 scores, and slightness 19-24 scores. Conclusions The GAP is simple, practical and accurate in diagnosing patients' traumatic condition and predicting their fatality rate. It is helpful in physicians' decision of a proper treatment plan. Key words: Trauma severity indices; Wounds and injuries; Fatality rate