Trauma Scoring Systems Research Articles

Trauma scoring

ABSTRACTSince their inception, trauma scoring systems have developed to become a valuable aid in the management of traumatised patients, and in trauma audit and research. This article reviews the accepted trauma scoring methods and the attributes and weaknesses of each. Scoring systems may be useful at an individual patient, departmental and national level, with the TRISS methodology being particularly useful in national audit. The fundamental drawbacks affecting all systems are discussed along with the advances anticipated in the next few years.

History and Current Status of Trauma Scoring Systems

The concept of scoring systems for trauma is relatively new. Triage systems were first developed in the late 1960s and early 1970s. Increased organization of trauma systems since that time has emphasized the importance of getting the right patient to the right hospital at the right time and has resulted in continued interest in triage systems. Increased organization has also spurred interest in sophisticated scoring systems for quantifying expected outcomes, assessing results of trauma care, and comparing large groups of patients. Ubiquitous use of acronyms for the different systems and the sometimes complex statistics on which they are based can make trauma scoring systems seem dauntingly complex. There are many potential uses of trauma scoring systems. 1 Field triage of patients to appropriate levels of care has already been mentioned. Quantifiable systems can also be used for quality assurance. Large groups of patients can be screened for unexpected outcomes, and

Functional Outcome of Pediatric Trauma Patients Identified as ‘Non-Salvageable Survivors’

A retrospective study of 305 pediatric trauma patients seen over 17 months was undertaken to evaluate the functional outcome of patients categorized as "non-salvageable survivors" (NSS). Functional outcome was determined by Denver Developmental Screen Tests (DDST) for children less than 5 years of age and Rappaport Severity Rating Scale (RDRS) for those 5 years old and older. Each patient was assigned Abbreviated Injury Scores (AIS). Injury Severity Score (ISS), Glasgow Coma Scale (GCS), and Trauma Score (TS). The total number of patients classified as severe was 65 (21%), and 13 were classified as non-salvageable, with seven non-salvageable survivors and six non-preventable deaths. Our study suggests that current trauma scoring systems tend to overestimate the non-salvageable population. Those identified as non-salvageable and who survived have a high probability of meaningful functional recovery. Current trauma scoring systems are in need of revision to better identify non-salvageable survivors and those children who will not make a meaningful neurologic recovery.