Background
High-flow trauma centers face a huge variety of injury patterns and severity warranting an objective measure to reflect injury severity and consequently the intensity of care required in a resource-limited environment. The revised trauma score (RTS) is a physiological triage system based upon Glasgow coma scale, systolic blood pressure, and respiratory rate that can be used as a prognostic tool in trauma patients.
Patients and methods
During the initial assessment of 200 blunt trauma victims presenting to Kasr Al Ainy emergency department between October 2015 and February 2016, the RTS was calculated and correlated with injury severity, discharge from the emergency room after initial assessment, ICU admission, length of hospital stay, and mortality. A cut-off RTS was thought to guide the decision-making process and anticipation of the required resources.
Results
An overall 78.5% of male individuals and 21.5% of female individuals with a mean age of 31.2 years with blunt abdominal trauma presented with a mean RTS of 11.41. No patient with an RTS of 10 or less could be discharged home from the emergency department. There was a statistically significant correlation between RTS and ICU admission and mortality (<0.001 for both). A cut-off RTS of less than 11 (RTS=10 or less) predicts mortality with a sensitivity of 92.9% and specificity of 81.8%, with area under the curve=0.929. Correlation between RTS and length of hospital stay did not reveal statistical significance (=0.310).
Conclusion
RTS can support the discharge decision process and reflect injury severity by predicting the need for ICU and mortality.