The correlation between Shock Index, TRISS, MGAP, NTS, MESS, and MEWS for prediction of outcome in patients with multiple trauma

Abstract

There are various scoring indices for predicting the severity of injury and predicting death and prognosis in trauma patients, and various studies have investigated the role of these indices in predicting death and severity of injury; However, no study has been done to determine the relationship between these scoring indicators. The present study aimed to investigate the relationship between scoring indices to predict survival in moderate and severe trauma patients. Methods: This cross-sectional study was conducted among 100 trauma patients of Imam Reza Tabriz Hospital in 2022-2023. The samples were selected by the enumeration method and the information was collected through the checklist made by the researcher. In moderate and severe trauma patients, the information of each index Shock Index, GAP, RGAP, NTS, MGAP, MEWS, and TRISS was completed separately with the respective checklists. Student T-test, Mann-Whitney U, and ROC curve were used to check the correlation and comparison of indicators in determining and predicting survival and health outcomes. Statistical analysis was done in SPSS software version 21. Results: Death was reported for 10% of trauma patients and the rest of the patients were transferred alive to the inpatient department, ICU, or operating room. In addition, 75.3% of multi-trauma patients had morbidity. There was no statistically significant difference between the surviving and deceased patients in terms of Shock Index, GAP, RGAP, NTS, M.GAP, MEWS, and TRISS. While between the two groups of multi-trauma patients with and without morbidity, a significant difference was observed in terms of all these indicators. According to the AUC, a value of less than 92.5 for the SPO2 variable was the best cut-off point for predicting the probability of death in multi-trauma patients. Also, according to the results of rock curves, SPO2 > 95.5, GCS score < 7.5 and RR < 19.5, GAP score < 14.5, RGAP score < 13.5, MGAP < 18, TRISS score < 54.2, MEWS score > 3.5, and NTS score < 14.5 were obtained as the best cut-off points for predicting the possibility of morbidity in multi-trauma patients.