POLYTRAUMA

EPIDEMIOLOGY & PROGNOSIS VERSUS TRAUMA SCORE

Abstract

Objective: To study the epidemiology of trauma and prognostic significance
of various trauma score systems. Design: A multi-center descriptive study Place and duration of study: The study
was conducted from July 1995 to March 2005 comprising almost 10 years in services hospitals of Lahore, Malir, Sialkot,
and Mianwali. Patients and Methods: 271 patients of various age groups were studied. Cases were grouped as burns,
head injuries and multisystem injuries and were managed according to Advance Trauma Life Support (ALTS) and
parameters of various trauma scores recorded and compared with outcome. Results: Probability of survival as
calculated by TRISS methodology has better prognostic significance than various trauma score systems alone. The
study revealed low specificity in all types of injuries showing late deaths and unexpected complications. Revised Trauma
Score and TRISS methodology were more accurate in multiple injuries than in burn and head injuries. Conclusion:
Revised Trauma Score (RTS) is useful tool as triage and prognostic indicator for multiple injuries but not in cases of
burns and head injuries. We need to develop our own norms and coefficients for TRISS methodology and unexpected
outcome should be minimized by sound clinical judgment. Moreover, we need radical improvement in burn care and
neuro-surgical facilities in our country