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중증 노인 외상에서 사망 예측을 위한 손상 점수 체계 간의 비교

Comparison of the new and conventional injury severity scoring systems for predicting mortality in severe geriatric trauma

대한응급의학회지 2020년 31권 6호 p.543 ~ 552
류호완, 안재윤, 서강석, 박정배, 김종근, 이미진, 류현욱, 김윤정, 김창호, 최재영, 이동언, 여인환, 문성배, 조연주, 정한솔, 조재완, 정해원,
소속 상세정보
류호완 ( Ryu Ho-Wan ) - Kyungpook National University School of Medicine Department of Emergency Medicine
안재윤 ( Ahn Jae-Yun ) - Kyungpook National University School of Medicine Department of Emergency Medicine
서강석 ( Seo Kang-Suk ) - Kyungpook National University School of Medicine Department of Emergency Medicine
박정배 ( Park Jung-Bae ) - Kyungpook National University School of Medicine Department of Emergency Medicine
김종근 ( Kim Jong-Kun ) - Kyungpook National University School of Medicine Department of Emergency Medicine
이미진 ( Lee Mi-Jin ) - Kyungpook National University School of Medicine Department of Emergency Medicine
류현욱 ( Ryoo Hyun-Wook ) - Kyungpook National University School of Medicine Department of Emergency Medicine
김윤정 ( Kim Yun-Jeong ) - Kyungpook National University School of Medicine Department of Emergency Medicine
김창호 ( Kim Chang-Ho ) - Kyungpook National University School of Medicine Department of Emergency Medicine
최재영 ( Choe Jae-Young ) - Kyungpook National University School of Medicine Department of Emergency Medicine
이동언 ( Lee Dong-Eun ) - Kyungpook National University School of Medicine Department of Emergency Medicine
여인환 ( Yeo In-Hwan ) - Kyungpook National University School of Medicine Department of Emergency Medicine
문성배 ( Moon Sung-Bae ) - Kyungpook National University School of Medicine Department of Emergency Medicine
조연주 ( Cho Yeon-Joo ) - Kyungpook National University School of Medicine Department of Emergency Medicine
정한솔 ( Chung Han-Sol ) - Kyungpook National University School of Medicine Department of Emergency Medicine
조재완 ( Cho Jae-Wan ) - Kyungpook National University School of Medicine Department of Emergency Medicine
정해원 ( Jung Hae-Won ) - Kyungpook National University School of Medicine Department of Emergency Medicine

Abstract


Objective: This study compared the prognostic performance of the following five injury severity scores: the Geriatric Trauma Outcome Score (GTOS), the Injury Severity Score (ISS), the New Injury Severity Score (NISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS) for in-hospital mortality in severe geriatric trauma patients.

Method: A retrospective, cross-sectional, observational study was conducted using a database of severe geriatric trauma patients (age ≥65 years and ISS ≥16) who presented to a single regional trauma center between November 2016 and October 2018. We compared the baseline characteristics between the survivor and mortality groups and the predictive ability of the five scoring systems.

Results: A total of 402 patients were included in the analysis; the in-hospital mortality rate was 25.6% (n=103). The TRISS had the highest area under the curve of 0.953 (95% confidence interval [CI], 0.927-0.971); followed by RTS, 0.777 (95% CI, 0.733-0.817); NISS, 0.733 (95% CI, 0.687-0.776); ISS, 0.660 (95% CI, 0.612-0.707); and GTOS, 0.660 (95% CI, 0.611-0.706) in severe geriatric trauma. The TRISS also had the highest area under the curve of 0.961 (0.919-0.985) among the injury severity scoring systems in polytrauma. The predictive ability of TRISS was significantly higher than the other four scores with respect to overall trauma and polytrauma (P<0.001).

Conclusion: The TRISS showed the highest prognostic performance for predicting in-hospital mortality among all the injury severity scoring systems in severe geriatric trauma.

키워드

Wounds and injuries; Assessment, Geriatric; Mortality; Prognosis

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