DOI: http://dx.doi.org/10.18203/2349-2902.isj20201863

A study to validate thoracic trauma severity score in chest trauma patients

Amit K. Sharma, Shaitan S. Rathore, Vijay Verma, Parul Yadav

Abstract


Background: Aim of this study was to validate thoracic trauma severity score (TTSS) in assessing the requirement of mechanical ventilation, mortality, and predicting prognosis in chest injury patients.

Methods: This study was conducted in department of general surgery, Dr. S. N. Medical College, Jodhpur, Rajasthan, from December 2018 to September 2019. This was a single centred, prospective, observational study, conducted in 110 patients, aged >18 years, of isolated chest injury, excluding polytrauma patients. Data was summarized in the form of proportions, histograms and tables to show relationships of parameters with results. Data was presented as mean±SD and proportions as appropriate. Chi square test, z test or t tests were used wherever necessary for association analysis between categorical variables. Diagnostic test characteristics for mortality and complications was calculated from the ROC curves. A two sided of p values of less than 0.05 was considered statistically significant.

Results: Most common mode of chest injury was blunt trauma and most common age group affected was 42-54 years. Maximum mortality was seen in TTSS between 16-20, shows higher the TTSS more the mortality. Ventilator requirement was more in high TTSS. Patients with higher TTSS had longer hospital stay as compared to patients with lower TTSS.

Conclusions: On application of TTSS on admission, TTSS had direct correlation with need for oxygenation, ventilator need, duration of hospital stay, mortality or outcome in chest trauma patients. Thus we recommend TTSS as a good useful score for evaluation of prognosis, outcome and mortality in chest trauma patients.

 


Keywords


FiO2, FAST, HRCT, PaO2, SpO2

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References


Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma. 1994;37(6):975-9.

Pape HC, Remmers D, Rice J, Ebisch M, Krettek C, Tscherne H. Appraisal of early evaluation of blunt trauma chest: development of a standardized scoring system for initial clinical decision making. J Trauma. 2000;49(3):496-504.

Seong HM, Jong WK, Joung HB, Sung HK, Jun YC, In SJ, Chung EL, Jun HY, Dong HK, Ki NK, Hyun OP. The thorax trauma severity score and the trauma and injury severity score: Do they predict in-hospital mortality in patients with severe thoracic trauma? Med. 2017;96(42):e8317.

Okabe Y. Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective case–control study. Acu Med Surg. 2018;5:166-72.

Elbaih AH, Elshapowry IM, Kalil NG, El-Aouty H. Evaluation of thoracic trauma severity score in predicting the outcome of isolated blunt chest trauma patients. Int J Surg Med. 2016;2(3):100-6.

Casas MI, Marchante MA, Paduraru M, Olea AI, Nolasco A, Medina JC. Thorax trauma severity score: is it reliable for patient's evaluation in a secondary level hospital? Bull Emerg Trauma. 2016;4(3):150-5.

Daurat A, Millet I, Roustan JP, Maury C, Taourel P, Jaber S, et al. Thoracic trauma severity score on admission allows to determine the risk of delayed ARDS in trauma patients with pulmonary contusion. Injury. 2016;47(1):147-53.

Subhani SS, Muzaffar MS, Khan MI. Comparison of outcome between low and high thoracic Trauma severity score in blunt trauma chest patients. J Ayub Med Coll Abbottabad. 2014;26(4):474-7.

Aukema TS, Beenen LF, Hietbrink F, Leenen LP. Validation of the thoracic trauma severity score for mortality and its value for the development of acute respiratory distress syndrome. Open Access Emerg Med. 2011;23(3):49-53.

Mommsen P, Zeckey C, Andruszkow H, Weidmann J, Fromke C, Griensven MV, et al. Comparison of different thoracic trauma systems in regard to prediction of post traumatic complications and outcome in blunt chest trauma. J Surg Res. 2012;176,239-47.