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J Korean Soc Emerg Med > Volume 31(6); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(6): 543-552.
중증 노인 외상에서 사망 예측을 위한 손상 점수 체계 간의 비교
류호완 , 안재윤 , 서강석 , 박정배 , 김종근 , 이미진 , 류현욱 , 김윤정 , 김창호 , 최재영 , 이동언 , 여인환 , 문성배 , 조연주 , 정한솔 , 조재완 , 정해원
경북대학교 의과대학 응급의학교실
Comparison of the new and conventional injury severity scoring systems for predicting mortality in severe geriatric trauma
Ho Wan Ryu , Jae Yun Ahn , Kang Suk Seo , Jung Bae Park , Jong Kun Kim , Mi Jin Lee , Hyun Wook Ryoo , Yun Jeong Kim , Changho Kim , Jae Young Choe , Dong Eun Lee , In Hwan Yeo , Sungbae Moon , Yeonjoo Cho , Han Sol Chung , Jae Wan Cho , Haewon Jung
Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
Correspondence  Jae Yun Ahn ,Tel: 053-200-6400, Fax: 053-428-2820, Email: jyahn@knu.ac.kr,
Received: June 3, 2020; Revised: July 15, 2020   Accepted: July 17, 2020.  Published online: December 30, 2020.
ABSTRACT
Objective:
This study compared the prognostic performance of the following five injury severity scores: the Geriatric Trauma Outcome Score (GTOS), the Injury Severity Score (ISS), the New Injury Severity Score (NISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS) for in-hospital mortality in severe geriatric trauma patients.
Method:
A retrospective, cross-sectional, observational study was conducted using a database of severe geriatric trauma patients (age ≥65 years and ISS ≥16) who presented to a single regional trauma center between November 2016 and October 2018. We compared the baseline characteristics between the survivor and mortality groups and the predictive ability of the five scoring systems.
Results:
A total of 402 patients were included in the analysis; the in-hospital mortality rate was 25.6% (n=103). The TRISS had the highest area under the curve of 0.953 (95% confidence interval [CI], 0.927-0.971); followed by RTS, 0.777 (95% CI, 0.733-0.817); NISS, 0.733 (95% CI, 0.687-0.776); ISS, 0.660 (95% CI, 0.612-0.707); and GTOS, 0.660 (95% CI, 0.611-0.706) in severe geriatric trauma. The TRISS also had the highest area under the curve of 0.961 (0.919-0.985) among the injury severity scoring systems in polytrauma. The predictive ability of TRISS was significantly higher than the other four scores with respect to overall trauma and polytrauma (P<0.001).
Conclusion:
The TRISS showed the highest prognostic performance for predicting in-hospital mortality among all the injury severity scoring systems in severe geriatric trauma.
Key words: Wounds and injuries; Assessment, Geriatric; Mortality; Prognosis
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