|Author:||Yuen, Suk Yin Margaret|
|Title:||Development of a simplified emergency trauma score for rating injury severity and predicting mortality in emergency setting|
|Subject:||Hong Kong Polytechnic University -- Dissertations|
Wounds and injuries -- Classification
|Department:||Faculty of Health and Social Sciences|
|Pages:||126 pages : color illustrations|
|Abstract:||Introduction: Trauma scores were developed in the 80s in the developed countries and have been used in assessing injury severity as well as predicting mortality of the injured by the trauma registries. However, they were not used in the emergency setting because of data availability and ease of coding issues. Aim: The aim of the study was to develop a Simplified Emergency Trauma Score (SETS) and Modified SETS (mSETS) for rating injury severity as well as triaging and predicting mortality in emergency setting. Method: A retrospective cohort analysis of trauma patients from the Local Studied Cluster Trauma Registry was conducted. SETS and mSETS were developed based on trauma database from 2007 to 2009 and validated by 2010 to 2011 database. Potential parameters in predicting mortality were identified by univariate analysis. Binary logistic regression was used to develop the equation of SETS and mortality analysis was used to develop the equation of mSETS, which were eventually compared with the commonly used trauma scores using receiver operating characteristic curves. Results: A total of 1,057 patients' records were used in developing SETS and mSETS, 850 patients' records were used in validating it. Four parameters, namely age, Glasgow Coma Scale, respiratory rate and injury were identified. A simplified regression equation was established in SETS. At cutoff point of 60 of SETS, the sensitivity and specificity of SETS were 61% and 98% respectively. The area under the receiver operating characteristic curve of SETS was 0.939 in the validating database, which was comparable with other commonly used trauma scores. Likewise at cutoff point of 2 of mSETS, the sensitivity and specificity of mSETS were 65% and 95%. The area under the receiver operating characteristic curves of mSETS was 0.896. Pilot study of mSETS was carried out in January and February 2017, with objectives of testing the applicability of mSETS at Triage Station for injured patients and predictive ability with mortality. There were total 135 patients recruited in the study. In mortality analysis, it was noted that mSETS was directly proportional to the prediction of mortality; the area under the receiver operating characteristic curse of mSETS in the pilot was 0.991. Conclusions: SETS and mSETS should be considered a relevant trauma scoring system in Hong Kong emergency setting. It is suggested that similar scoring systems should be developed in other countries based upon obtainable measures in their corresponding emergency settings.|
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