مقايسه توانايي روش هاي سنجش شدت كمي تروما در تعيين پيش آگهي بيماران

COMPARISON OF TRAUMA SCORING SYSTEMS FOR PREDICTION OF PATIENTSʹ PROGNOSIS

This study was done to compare the trauma scoring systems (ISS, RTS, CʹRISS and ASCOh) in prediction of patientsʹ outcome (including survival, hospital length of stay and hospital costs). A randomely selected sample of 525 cases were selected from patients who admitted to hospital for atleast 1 day and all in-hospital deceased patients. Totally, 6.5 percent of patients had died. Trauma severity of patients set was 8.57 (± 0.62) according to ʹSS. 7.59 (± 0.08) according to RTS. 1.8 (- 0.12) according to ʹMISS and 4.03 (+ 2.5) according to ASCOT. Trauma severity of survivors and non-survivors were significantly different using each of the above systems. The largest area under ROC curve was belonged to ASCOT following with TRISS, ISS and RTS. ISS had the greatest correlation with hospital length of stay (r 0.76, Pa 0.01) and costs (r 0.77. P< 0.01). There were significant regressions between each system point and hospital staying or charges, but even the greatest determination coefficient were not beyond the 0.37 (for hospital staying) and 0.36 (for hospital charges). ASCOT and TRISS had greater Precision to predict mortality and 1SS was the best predictor of hospital length of stay and charges. Using these Scoring methods in a National Surveillance System for Trauma is Recommended.