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Trauma severity scoring to predict mortality

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Abstract

The evaluation of the care of the multiple trauma patient requires indices that predict survival or death and that reveal the presence or absence of complications. This article reviews briefly the different scales that have been developed. It is concluded that both anatomic and physiologic injury scores are required. A methodology of patient care evaluation is then developed based upon preliminary method (PRE), a state transition screen (STS), and a definitive method (DEF). The preliminary method is illustrated by use of the Trauma Score and the Injury Severity Score to predict patient outcome. This is then compared with the actual patient outcome. The STS methodology reveals patients who are better or worse than expected in their course in the hospital. The DEF method is used for comparison between institutions or for different time periods at a given institution.

Résumé

L'appréciation exacte du traitement des polytraumatisés nécessite la définition de repères indicatifs qui permettent de prédire la survie ou le décès et qui révèlent la présence ou l'absence de complications. Cet article fasse en revue les différentes méthodes d'évaluation qui ont été retenues. Leur étude a conduit à la conclusion que des éléments anatomiques aussi bien que des éléments physiologiques sont à prendre en considération.

L'évaluation de ces facteurs répond à trois étapes: étape préliminaire (PRE), étape de transition (STS), étape définitive (DEF). L'évaluation préliminaire repose sur l'emploi d'une échelle de gravité traumatique. Pour une blessure donnée elle repose sur les données obtenues en prenant en compte l'état général du blessé. L'évaluation intermédiaire permet de préjuger de l'évolution différente que celle envisagée initialement que ce soit dans un sens favorable ou défavorable.

Cette méthode permet de comparer les résultats obtenus par les différents centres de soins et pour une même institution de connaître l'évolution des résultats.

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Author information

Authors and Affiliations

  1. Surgical Critical Care Services, Washington Hospital Center, 110 Irving Street, 20010, Washington, D.C., N.W., USA

    Howard R. Champion F.R.C.S. (Edin.) (Director), William J. Sacco Ph.D. & Thomas K. Hunt M.D., F.A.C.S., F.R.C.S. (Glas.)

  2. University of California Medical Center, San Francisco, California, USA

    Howard R. Champion F.R.C.S. (Edin.) (Director), William J. Sacco Ph.D. & Thomas K. Hunt M.D., F.A.C.S., F.R.C.S. (Glas.)

Authors
  1. Howard R. Champion F.R.C.S. (Edin.)
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  2. William J. Sacco Ph.D.
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  3. Thomas K. Hunt M.D., F.A.C.S., F.R.C.S. (Glas.)
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Additional information

Supported in part by a National Center for Health Services Research Grant No. R18 HS 02559.

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Champion, H.R., Sacco, W.J. & Hunt, T.K. Trauma severity scoring to predict mortality. World J. Surg. 7, 4–11 (1983). https://doi.org/10.1007/BF01655906

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