The Comparison of Triage Trauma Scores Used in the Emergency Department

Abstract

Study Objective: More than 50 scoring systems have been developed for the classification of the injury severity and prediction of the prognosis of trauma patients. Most of the scoring systems have been developed and validated in United States. In our study, we aimed to evaluate the emergency department performance of Glasgow Coma Scale (GCS); triage - revised trauma scores (T-RTS), circulation, respiration, abdomen, motor and speech (CRAMS) scale and trauma triage rule (TTR).
Methods: Between the dates of January 1, 1997 and June 30, 1997, 1063 trauma patients presented to Emergency Department of Dokuz Eylul University Hospital were screened retrospectively. Major trauma patients determined for each scoring systems, GCS, T-RTS, CRAMS and TTR. These patients were compared with the American College of Emergency Physicians (ACEP) policy definition of major trauma patients. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated for each scoring system.
Results: 1063 of 1399 trauma patients were included into the study. 336 patients were excluded from the study because 112 files were lost and 224 files contained insufficient data. Among the study patients, 59%of the patients were male and 41%were female. The mean age of the population was 40±17. 168 patients (15.8%) were defined as major trauma patients according to ACEP policy definition. 17 (1.6%) patients were determined as major trauma patient according to GCS, 73 (7.1%) to T-RTS, 52 (4.8%) to CRAMS and 43 (4%) to TTR. T-RTS was found as the most sensitive scoring system (sensitivity 32%, specificity 98%, PPV 73%, NPV 88%and accuracy 87%).
Conclusions: According to ACEP policy definition of major trauma criterion, we determined T-RTS as the most useful trauma scoring system in our country.