Temat: Revised Trauma Score

Skocz do pozycji: 1.

Tytuł:: Is whole-body trauma MDCT justified in patients in good clinical condition but with dangerous trauma mechanism?
Autorzy:: Palczewski, Piotr
Wisniewska, Malgorzata
Golebiowski, Marek
Blaz, Marcin
Swiatkowski, Jan
Szeszkowski, Wojciech
Opis:: Background: To assess whether whole body MDCT is justified in patients in good clinical condition yet with dangerous trauma mechanism. Material/Methods: The study included 81 patients who were examined between January and July 2008 with wholebody trauma CT protocol. Inclusion into the study was based on a dangerous trauma mechanism and the possibility of an unbiased calculation of the weighted revised trauma score (RTSw). All examinations were performed with 16 row MDCT scanner located in emergency department. The cut off of the RTSw over 6.0 was used to separate the patients in good clinical condition. The CT examinations and medical records of patients were reviewed to assess the number of significant injuries, the need for emergency surgery and other types of medical treatment, the number of negative CT examinations, the number of patients admitted to hospital, and mortality. Results: 28 life-threatening injuries were found in 21 of 61 patients with RTS over 6.0 (34.4%). Only two of those patients required emergency surgery (laparotomy). CT studies were negative for traumatic injuries in 22 patients from this group (36.0%). Conclusions: Whole-body MDCT may detect injuries in patients in good clinical condition, with some of them demanding medical treatment. Still, further studies are required to balance the advantages of MDCT and potentially harmful effects of radiation dose, especially better triage systems and lowdose protocols are needed.
Dostawca treści:: Repozytorium Uniwersytetu Jagiellońskiego

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Skocz do pozycji: 2.

Tytuł:: Additional data from clinical examination on site significantly but marginally improve predictive accuracy of the Revised Trauma Score for major complications during Helicopter Emergency Medical Service missions
Autorzy:: Sterliński, Maciej
Gałązkowski, Robert
Marciniak-Emmons, Marta
Darocha, Tomasz
Farkowski, Michał M.
Timler, Dariusz
Rabczenko, Daniel
Opis:: Introduction: The Revised Trauma Score (RTS) accurately identifies trauma patients at high risk of adverse events or death. Less is known about its usefulness in the general population and non-trauma recipients of Helicopter Emergency Medical Service (HEMS). The RTS is a simple tool and omits a lot of other data obtained during clinical evaluation. The aim was to assess the role of the RTS to identify patients at risk of major complications (death, cardiopulmonary resuscitation, defibrillation, intubation) in the general population of HEMS patients. Clinical factors beyond the RTS were analyzed to identify additional prognostic factors for predicting major complications. Material and methods: A retrospective analysis of medical records of adult patients routinely collected during HEMS missions in the years 2011-2014 was performed. Results: The analysis included 19 554 HEMS missions. Patients were 55 ±20 years old and 68% were male. The most common indication for HEMS was diseases of the circulatory system - 41%. Major complications occurred in 2072 (10.6%) cases. In the general population of HEMS patients, the RTS accurately identified individuals at risk of major complications at a cut-off value of 10.5 and area under the curve (AUC) of 93.5%. In multivariate analysis, additional clinical data derived from clinical examination (ECG; skin, pupil and breathing examination) significantly but marginally improved the accuracy of RTS assessment: AUC 95.6% (p < 0.001 for the difference). Conclusions: The Revised Trauma Score accurately identifies individuals at risk of major complications during HEMS missions regardless of the indication. Additional clinical data significantly but marginally improved the accuracy of RTS in the general population of HEMS patients
Dostawca treści:: Repozytorium Uniwersytetu Jagiellońskiego

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Skocz do pozycji: 3.

Tytuł:: Evaluation of ISS, RTS, CASS and TRISS scoring systems for predicting outcomes of blunt trauma abdomen
Autorzy:: Alam, Arshad
Gupta, Arun
Gupta, Nikhil
Yelamanchi, Raghav
Bansal, Lalit
Durga, C
Tematy:: blunt trauma abdomen
Clinical Abdominal Scoring System
Injury Severity Score
Revised Trauma Score
Trauma and Injury Severity Score; Pokaż więcej
Wydawca:: Index Copernicus International
Powiązania:: https://bibliotekanauki.pl/articles/1391304.pdf Link otwiera się w nowym oknie
Opis:: Introduction: Trauma is the leading cause of mortality in people below the age of 45 years. Abdominal trauma constitutes one-fourth of the trauma burden. Scoring systems in trauma are necessary for grading the severity of the injury and prior mobilization of resources in anticipation. Aim: The aim of this study was to evaluate RTS, ISS, CASS and TRISS scoring systems in blunt trauma abdomen. Materials and methods: A prospective single-center study was conducted on 43 patients of blunt trauma abdomen. Revised trauma score (RTS), Injury Severity Score (ISS), Clinical Abdominal Scoring System (CASS) and Trauma and Injury Severity Score (TRISS) were calculated and compared with the outcomes such as need for surgical intervention, post-operative complications and mortality. Results: The majority of the study subjects were males (83.7%). The most common etiology for blunt trauma abdomen as per this study was road traffic accident (72.1%). Spleen was the most commonly injured organ as per the study. CASS and TRISS were significant in predicting the need for operative intervention. Only ISS significantly predicted post-operative complications. All scores except CASS significantly predicted mortality. Conclusions: Among the scoring systems studied CASS and TRISS predicted the need for operative intervention with good accuracy. For the prediction of post-operative complications, only the ISS score showed statistical significance. ISS, RTS and TRISS predicted mortality with good accuracy but the superiority of one score over the other could not be proved.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 4.

Tytuł:: Ewaluacja skal ISS, RTS, CASS i TRISS w ocenie rokowania u pacjentów po urazie tępym jamy brzusznej
Autorzy:: Alam, Arshad
Gupta, Arun
Gupta, Nikhil
Yelamanchi, Raghav
Bansal, Lalit
Durga, C
Tematy:: Clinical Abdominal Scoring System
Injury Severity Score
Revised Trauma Score
Trauma and Injury Severity Score
uraz tępy jamy brzusznej; Pokaż więcej
Wydawca:: Index Copernicus International
Powiązania:: https://bibliotekanauki.pl/articles/1391277.pdf Link otwiera się w nowym oknie
Opis:: Wstęp: Urazy pozostają główną przyczyną zgonów u osób poniżej 45. r.ż. Jedną czwartą wszystkich urazów stanowią urazy jamy brzusznej. Skale kliniczne stosowane w urazach są niezbędne dla oceny ich ciężkości i wcześniejszego zorganizowania środków w oczekiwaniu na przyjazd chorego. Cel: Celem badania była ocena zastosowania skal RTS, ISS, CASS i TRISS w urazach tępych jamy brzusznej.Materiały i metody: Przeprowadzono prospektywne jednoośrodkowe badanie kliniczne na 43 pacjentach z urazem tępym jamy brzusznej. Obliczono wyniki w: skali oceny ciężkości urazów (RTS), skali oceny ciężkości mnogich obrażeń ciała (ISS), klinicznej skali oceny jamy brzusznej (CASS) oraz w skali ciężkości urazu i obrażeń (TRISS), a także porównano je z punktami końcowymi, takimi jak: potrzeba leczenia zabiegowego, powikłania pooperacyjne i zgon.Wyniki: W niniejszym badaniu większość stanowili mężczyźni (83,7%). Uraz jamy brzusznej był głównie wynikiem wypadku komunikacyjnego (72,1%). Najczęściej dochodziło do urazu śledziony. Wyniki CASS i TRISS były istotne w przewidywaniu potrzeby interwencji zabiegowej. Jedynie dla ISS wykazano istotność w przewidywaniu powikłań pooperacyjnych. Wszystkie skale, z wyjątkiem CASS, istotnie przewidywały ryzyko zgonu. Wnioski: Spośród przeanalizowanych skal, CASS i TRISS przewidywały konieczność interwencji zabiegowej z dobrą dokładnością. W przypadku ryzyka powikłań pooperacyjnych jedynie wynik w skali ISS wykazywał istotność statystyczną. Skale ISS, RTS i TRISS przewidywały zgon z dużą dokładnością, bez przewagi jednej ze skal nad pozostałymi.
Dostawca treści:: Biblioteka Nauki

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