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Original Articles
- Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea
- Hongrye Kim, Mou Seop Lee, Su Young Yoon, Jonghee Han, Jin Young Lee, Junepill Seok
- Received December 20, 2023 Accepted January 26, 2024 Published online May 9, 2024
- DOI: https://doi.org/10.20408/jti.2023.0087 [Epub ahead of print]
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Abstract
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Supplementary Material - Purpose
Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients.
Methods
Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma.
Results
In total, 1,038 patients were divided into two groups: those with complications (822, 79.2%) and those with no complications (216, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5–15] vs. 15 [14–15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively)
Conclusions
Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended. -
Summary
- Clinical characteristics and mortality risk factors among trauma patients by age groups at a single center in Korea over 7 years: a retrospective study
- Jonghee Han, Su Young Yoon, Junepill Seok, Jin Young Lee, Jin Suk Lee, Jin Bong Ye, Younghoon Sul, Seheon Kim, Hong Rye Kim
- J Trauma Inj. 2023;36(4):329-336. Published online November 7, 2023
- DOI: https://doi.org/10.20408/jti.2023.0035
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Abstract
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- Purpose
In this study, we aimed to compare the characteristics of patients with trauma by age group in a single center in Korea to identify the clinical characteristics and analyze the risk factors affecting mortality.
Methods
Patients aged ≥18 years who visited the Chungbuk National University Hospital Regional Trauma Center between January 2016 and December 2022 were included. The accident mechanism, severity of the injury, and outcomes were compared by classifying the patients into group A (18–64 years), group B (65–79 years), and group C (≥80 years). In addition, logistic regression analysis was performed to identify factors affecting death.
Results
The most common injury mechanism was traffic accidents in group A (40.9%) and slipping in group B (37.0%) and group C (56.2%). Although group A had the highest intensive care unit admission rate (38.0%), group C had the highest mortality rate (9.5%). In the regression analysis, 3 to 8 points on the Glasgow Coma Scale had the highest odds ratio for mortality, and red blood cell transfusion within 24 hours, intensive care unit admission, age, and Injury Severity Score were the predictors of death.
Conclusions
For patients with trauma, the mechanism, injured body region, and severity of injury differed among the age groups. The high mortality rate of elderly patients suggests the need for different treatment approaches for trauma patients according to age. Identifying factors affecting clinical patterns and mortality according to age groups can help improve the prognosis of trauma patients in the future. -
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