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J Korean Soc Emerg Med > Volume 27(2); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(2): 199-205.
중증 외상 환자의 예후 판정을 위한 지표로 Rapid Emergency Medicine Score의 사용: Emergency Trauma Score 및 Injury Severity Score와 비교
이상훈, 박준민, 박준석, 김경환, 신동운, 전우찬, 김현종, 김훈
인제대학교 의과대학 일산백병원 응급의학과
Utility of the Rapid Emergency Medicine Score (REMS) for Predicting Hospital Mortality in Severely Injured Patients
Sang Hoon Lee, Joon Min Park, Jun Seok Park, Kyung Hwan Kim, Dong Wun Shin, Woo Chan Jeon, Hyun Jong Kim, Hoon Kim
Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Gyeonggido, Korea
Correspondence  Joon Min Park ,Tel: 031) 910-9781, Fax: 031) 910-7188, Email: aero7@hanmail.net,
Received: January 4, 2016; Revised: January 5, 2016   Accepted: February 29, 2016.  Published online: April 30, 2016.
ABSTRACT
Purpose:
We evaluated the power of the Rapid Emergency Medicine Score (REMS) for predicting hospital mortality in trauma patients. Then, we compared the REMS with two other scoring systems, the Emergency Trauma Score (EMTRAS) and the Injury Severity Score (ISS) for predicting prognosis.
Method:
We examined data from a prospectively collected registry in a single trauma center from January 2010 to November 2011. Patients enrolled in the registry were trauma patients who were predicted to have an ISS>15 or who required urgent multiple surgical consultations as soon as possible. Pediatric patients (<18-years-old) who were referred after initial care or death on arrival, and those with injuries due to burns, asphyxia, or drowning were excluded. The study population was divided into two subgroups according to hospital mortality, and the differences in clinical characteristics and calculated scores were examined. The odds ratio (OR) of REMS for predicting In-hospital mortality was calculated and the prognostic power of the three scoring systems for predicting hospital mortality by drawing receiver operating characteristic (ROC) curves was compared.
Results:
A total of 103 patients were included in the analysis. Of these, 44 died during hospitalization. All three prognostic scores were significantly higher in the hospital mortality subgroup. The OR of the REMS for predicting hospital mortality was 1.35 (p<0.001). The areas under the ROC curves of the REMS, EMTRAS, and ISS were 0.815 (95% confidence interval [CI], 0.727-0.884), 0.872 (95% CI, 0.793-0.930), and 0.693 (95% CI, 0.595-0.780), respectively. The area under the ROC curve of the REMS was not different from that of the EMTRAS or ISS.
Conclusion:
The REMS showed good prognostic power for predicting hospital mortality in severely injured patients. Consecutive prospective studies are warranted to determine the utility of this scoring system for trauma patients.
Key words: Trauma severity indices, Triage, Wounds and injuries, Mortality
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