성인 중증 외상환자에서 사망 예측을 위한 새로운 외상점수체계의 적용 (Application of New Trauma Scoring Systems for Mortality Prediction in Patients with Adult Major Trauma)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 25권 / 4호 / 447 ~ 455페이지
· 저자명 : 김양헌, 서강석, 이미진, 박정배, 김종근, 안재윤, 하소영, 류현욱, 문유호, 최승필

초록

Purpose: Various scoring systems have been introduced ingrading severity and predicting mortality of trauma patients.
The objective of this study is to apply novel trauma scoringsystems; BIG score (Base deficit (B), International normalizedratio (I), Glasgow Coma Scale (G)), EmergencyTrauma Score (EMTRAS), Probability of Survival score version12 (PS12), and MGAP (Mechanism, GCS, Age,Arterial pressure) to adults with major trauma, and to comparetheir performance with traditional systems; InjurySeverity System (ISS), Revised Trauma Score (RTS), andTrauma and Injury Severity Score (TRISS).
Methods: Retrospective data collected between January2011 and June 2012 from a regional trauma center registryon adult major trauma patients (Age≥18, ISS≥16) wereused to identify factors associated with death. Univariateassociations were calculated, and a multiple logistic regressionanalysis was used to determine variables associatedwith hospital mortality.
Results: A total of 298 adult major trauma patients wereretrieved in order to validate new trauma scoring systems.
The median ISS was 22 [interquartile range (IQR) 17~25],and the hospital mortality rate was 30.9%. Traditional traumascoring systems were each calculated to have an area underthe curve of ISS 0.72 [95% confidence interval (CI): 0.67-0.77], TRISS 0.91 (95% CI: 0.88-0.94), and RTS 0.90 (95%CI: 0.86-0.93). New trauma scoring systems were calculatedto have an area under the curve of EMTRAS 0.91 (95% CI:0.87-0.94), BIG score 0.90 (95% CI: 0.86-0.93), PS12 0.91(95% CI: 0.87-0.94), and MGAP 0.89 (95% CI: 0.85-0.93).
Conclusion: The new trauma scoring systems (EMTRAS,BIG, MGAP) were good predictors of mortality in adult majortrauma patients on admission. They performed well comparedto traditional trauma scoring systems (ISS, RTS, TRISS).

영어초록

Purpose: Various scoring systems have been introduced ingrading severity and predicting mortality of trauma patients.
The objective of this study is to apply novel trauma scoringsystems; BIG score (Base deficit (B), International normalizedratio (I), Glasgow Coma Scale (G)), EmergencyTrauma Score (EMTRAS), Probability of Survival score version12 (PS12), and MGAP (Mechanism, GCS, Age,Arterial pressure) to adults with major trauma, and to comparetheir performance with traditional systems; InjurySeverity System (ISS), Revised Trauma Score (RTS), andTrauma and Injury Severity Score (TRISS).
Methods: Retrospective data collected between January2011 and June 2012 from a regional trauma center registryon adult major trauma patients (Age≥18, ISS≥16) wereused to identify factors associated with death. Univariateassociations were calculated, and a multiple logistic regressionanalysis was used to determine variables associatedwith hospital mortality.
Results: A total of 298 adult major trauma patients wereretrieved in order to validate new trauma scoring systems.
The median ISS was 22 [interquartile range (IQR) 17~25],and the hospital mortality rate was 30.9%. Traditional traumascoring systems were each calculated to have an area underthe curve of ISS 0.72 [95% confidence interval (CI): 0.67-0.77], TRISS 0.91 (95% CI: 0.88-0.94), and RTS 0.90 (95%CI: 0.86-0.93). New trauma scoring systems were calculatedto have an area under the curve of EMTRAS 0.91 (95% CI:0.87-0.94), BIG score 0.90 (95% CI: 0.86-0.93), PS12 0.91(95% CI: 0.87-0.94), and MGAP 0.89 (95% CI: 0.85-0.93).
Conclusion: The new trauma scoring systems (EMTRAS,BIG, MGAP) were good predictors of mortality in adult majortrauma patients on admission. They performed well comparedto traditional trauma scoring systems (ISS, RTS, TRISS).

참고자료

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