Predictive value of TTSS (Thoracic Trauma Severity Score) in chest trauma with multiple trauma
Abstract
Chest trauma after head trauma in polytrauma is one of the main causes of death and includes 20 to 25% of all deaths caused by trauma in most parts of the world. Thoracic trauma severity score (TTSS) combines patient-related parameters with anatomical and physiological parameters. The TTSS score includes five parameters: age, PaO2/FiO2, pleural trauma, lung contusion and rib fracture, and the total score ranges from 0 to 25. However, the accuracy of this scoring system has not yet been clearly evaluated in Iranian hospitals. Therefore, this study was conducted in order to evaluate the predictive value of TTSS for predicting the outcome of chest trauma in the emergency department of Imam Reza Hospital.
Methods: In this study, multi-trauma patients who also had chest trauma and were treated in the emergency department of Imam Reza Hospital in Tabriz from the beginning of October 1402 to the end of March 1402 were included in the study using the full enumeration method. Each of the parameters of TTSS scale, age, gender and mechanism of injury were extracted and using the sensitivity ROC curve, the characteristic of TTSS was used to predict mortality in these patients.
Results: In this study, 212 patients were evaluated, more than half of them were less than 41 years old. Also, 170 people (80.2%) of them were men and 42 people (19.8%) were women. The mechanism of trauma in more than half of the subjects (54.3%) was a car-car accident. Also, 16 cases (7.5%) of in-hospital deaths were recorded in this study. In the ROC analysis related to the predictive power of TTSS in in-hospital mortality, TTSS could significantly predict mortality in multi-trauma patients with chest trauma (AUC=0.743, P-value=0.001, CI 95% [0.591-0.896]). Also, in this study, at the optimal cut point of 8.5, TTSS had a sensitivity of 68.8% and a specificity of 82.7%.
III
ضمائم
Also, in this study, TRISS had the same predictive power as TTSS in predicting in- hospital mortality, and Wagner system could not significantly predict mortality.