@article{ref1,
title="The role of trauma scoring in developing trauma clinical governance in the Defence Medical Services",
journal="Philosophical transactions of the Royal Society of London. Series B, Biological sciences",
year="2011",
author="Russell, R. J. and Hodgetts, T. J. and McLeod, J. and Starkey, K. and Mahoney, P. and Harrison, K. and Bell, E.",
volume="366",
number="1562",
pages="171-191",
abstract="This paper discusses mathematical models of expressing severity of injury and probability of survival following trauma and their use in establishing clinical governance of a trauma system. There are five sections: (i) Historical overview of scoring systems-anatomical, physiological and combined systems and the advantages and disadvantages of each. (ii) Definitions used in official statistics-definitions of 'killed in action' and other categories and the importance of casualty reporting rates and comparison across conflicts and nationalities. (iii) Current scoring systems and clinical governance-clinical governance of the trauma system in the Defence Medical Services (DMS) by using trauma scoring models to analyse injury and clinical patterns. (iv) Unexpected outcomes-unexpected outcomes focus clinical governance tools. Unexpected survivors signify good practice to be promulgated. Unexpected deaths pick up areas of weakness to be addressed. Seventy-five clinically validated unexpected survivors were identified over 2 years during contemporary combat operations. (v) Future developments-can the trauma scoring methods be improved? Trauma scoring systems use linear approaches and have significant weaknesses. Trauma and its treatment is a complex system. Nonlinear methods need to be investigated to determine whether these will produce a better approach to the analysis of the survival from major trauma.<p /> <p>Language: en</p>",
language="en",
issn="0962-8436",
doi="10.1098/rstb.2010.0232",
url="http://dx.doi.org/10.1098/rstb.2010.0232"
}