Value of Three Trauma Scaling Systems in Predicting Death for Patients in Mass Casualties_West China Medical Journal

Authors：

CHEN Xiaohong ,  HU Hai , CAO Yu.

Department of Emergency, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HU Hai, Email: 492550263@qq.com

Keywords：

群體傷; 修正創傷評分; CRAMS評分; 院前傷情評分

DOI：

10.7507/1002-0179.20130417

Video：

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目的　探討修正創傷評分（RTS）、CRAMS評分及院前傷情評分（PHI）對于群體傷患者死亡的評估作用。方法　回顧性分析2011年8月－2012年8月就診且記錄完整的45例群體傷患者的病歷資料，根據病歷記錄計算RTS、CRAMS及PHI評分，并記錄患者是否死亡。繪制受試者工作特征曲線并計算出曲線下面積；根據約登指數篩選出各個評分適宜的截斷值，據此計算3種創傷評分的靈敏度、特異度、陽性似然比、陰性似然比、陽性預測值、陰性預測值并進行比較。將患者按照性別、年齡分為亞組進行對比分析。結果　RTS曲線下面積最大，且與參考線下面積對比差異有統計學意義（P=0.016），與另外兩種評分比較其差異有統計學意義。結論　RTS較CRAMS及PHI評分對于群體傷患者死亡預測具有更高的價值。

Citation： CHEN Xiaohong,HU Hai,CAO Yu.. Value of Three Trauma Scaling Systems in Predicting Death for Patients in Mass Casualties. West China Medical Journal, 2013, 28(9): 1329-1332. doi: 10.7507/1002-0179.20130417 Copy

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4.	Sloan EP, Koenigsberg M, Clark JM, et al. The use of the Revised Trauma Score as an entry criterion in traumatic hemorrhagic shock studies: data from the DCLHb clinical trials[J]. Prehosp Disaster Med, 2012, 27(4): 330-344.
5.	Ornato J, Mlinek EJ, Craren EJ, et al. Ineffectiveness of the trauma score and the CRAMS scale for accurately triaging patients to trauma centers[J]. Ann Emerg Med, 1985, 14(11): 1061-1064.
6.	Gray A, Goyder EC, Goodacre SW, et al. Trauma triage: a comparison of CRAMS and TRTS in a UK population[J]. Injury, 1997, 28(2): 97-101.
7.	余翎. ISS與CRAMS創傷評分法在急診多發傷中的應用[J]. 現代實用醫學, 2004, 16(2): 99, 101.
8.	Lavoie A, Emond M, Moore L, et al. Evaluation of the prehospital index, presence of high-velocity impact and judgment of emergency medical technicians as criteria for trauma triage[J]. CJEM, 2010, 12(2): 111-118.
9.	Watts HF, Kerem Y, Kulstad EB. Evaluation of the revised trauma and injury severity scores in elderly trauma patients[J]. J Emerg Trauma Shock, 2012, 5(2): 131-134.
10.	Eichelberger MR, Gotschall CS, Sacco WJ, et al. A comparison of the trauma score, the revised trauma score, and the pediatric trauma score[J]. Ann Emerg Med, 1989, 18(10): 1053-1058.
11.	李寧, 楊健, 石應康, 等. 院前RTS評分促進早期醫療介入提高院前急救質量的探討[J]. 川北醫學院學報, 2003, 18(4): 4-6.
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1. 　劉君, 王杰. 突然群體傷患者救治傷程序的探討[J]. 實用心腦肺血管病雜志, 2010, 18(8): 1156.
2. 　丁家周, 易書貴, 蔡浩, 等. 道路交通事故成批傷員的救治[J]. 當代醫師雜志, 1996, 8(8): 55-56.
3. 　Gilpin DA, Nelson PG. Revised trauma score: a triage tool in the accident and emergency department[J]. Injury, 1991, 22(1): 35-37.
4. 　Sloan EP, Koenigsberg M, Clark JM, et al. The use of the Revised Trauma Score as an entry criterion in traumatic hemorrhagic shock studies: data from the DCLHb clinical trials[J]. Prehosp Disaster Med, 2012, 27(4): 330-344.
5. 　Ornato J, Mlinek EJ, Craren EJ, et al. Ineffectiveness of the trauma score and the CRAMS scale for accurately triaging patients to trauma centers[J]. Ann Emerg Med, 1985, 14(11): 1061-1064.
6. 　Gray A, Goyder EC, Goodacre SW, et al. Trauma triage: a comparison of CRAMS and TRTS in a UK population[J]. Injury, 1997, 28(2): 97-101.
7. 　余翎. ISS與CRAMS創傷評分法在急診多發傷中的應用[J]. 現代實用醫學, 2004, 16(2): 99, 101.
8. 　Lavoie A, Emond M, Moore L, et al. Evaluation of the prehospital index, presence of high-velocity impact and judgment of emergency medical technicians as criteria for trauma triage[J]. CJEM, 2010, 12(2): 111-118.
9. 　Watts HF, Kerem Y, Kulstad EB. Evaluation of the revised trauma and injury severity scores in elderly trauma patients[J]. J Emerg Trauma Shock, 2012, 5(2): 131-134.
10. 　Eichelberger MR, Gotschall CS, Sacco WJ, et al. A comparison of the trauma score, the revised trauma score, and the pediatric trauma score[J]. Ann Emerg Med, 1989, 18(10): 1053-1058.
11. 　李寧, 楊健, 石應康, 等. 院前RTS評分促進早期醫療介入提高院前急救質量的探討[J]. 川北醫學院學報, 2003, 18(4): 4-6.
12. 　Ahmad HN. Evaluation of revised trauma score in polytraumatized patients[J]. J Coll Physicians Surg Pak, 2004, 14(5): 286-289.

West China Medical Journal

Value of Three Trauma Scaling Systems in Predicting Death for Patients in Mass Casualties

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