Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea
Purpose Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients. Methods Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest comp...
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Korean Society of Traumatology
2024-06-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2023-0087.pdf |
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| author | Hongrye Kim Mou Seop Lee Su Young Yoon Jonghee Han Jin Young Lee Junepill Seok |
| author_facet | Hongrye Kim Mou Seop Lee Su Young Yoon Jonghee Han Jin Young Lee Junepill Seok |
| author_sort | Hongrye Kim |
| collection | DOAJ |
| description | Purpose Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients. Methods Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma. Results In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5–15] vs. 15 [14–15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively) Conclusions Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended. |
| format | Article |
| id | doaj-art-2423fbbeef584c88b74c5c977c6adb2d |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-2423fbbeef584c88b74c5c977c6adb2d2025-01-16T06:10:17ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832024-06-0137211412310.20408/jti.2023.00871305Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in KoreaHongrye Kim0Mou Seop Lee1Su Young Yoon2Jonghee Han3Jin Young Lee4Junepill Seok5 Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, Cheongju, Korea Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, Cheongju, Korea Department of Trauma Surgery, Chungbuk National University Hospital, Cheongju, Korea Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, Cheongju, KoreaPurpose Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients. Methods Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma. Results In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5–15] vs. 15 [14–15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively) Conclusions Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended.http://jtraumainj.org/upload/pdf/jti-2023-0087.pdfblunt chest traumaglasgow coma scaletrauma scoring systemsabbreviated injury scaletraumatic brain injuries |
| spellingShingle | Hongrye Kim Mou Seop Lee Su Young Yoon Jonghee Han Jin Young Lee Junepill Seok Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea Journal of Trauma and Injury blunt chest trauma glasgow coma scale trauma scoring systems abbreviated injury scale traumatic brain injuries |
| title | Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea |
| title_full | Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea |
| title_fullStr | Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea |
| title_full_unstemmed | Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea |
| title_short | Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea |
| title_sort | validation of chest trauma scoring systems in polytrauma a retrospective study with 1 038 patients in korea |
| topic | blunt chest trauma glasgow coma scale trauma scoring systems abbreviated injury scale traumatic brain injuries |
| url | http://jtraumainj.org/upload/pdf/jti-2023-0087.pdf |
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