TY  - JOUR
PY  - 2023//
TI  - Which curve is better? A comparative analysis of trauma scoring systems in a South Asian country
JO  - Trauma surgery and acute care open
A1  - Merchant, Asma Altaf Hussain
A1  - Shaukat, Natasha
A1  - Ashraf, Naela
A1  - Hassan, Sheza
A1  - Jarrar, Zeerak
A1  - Abbasi, Ayesha
A1  - Ahmed, Tanveer
A1  - Atiq, Huba
A1  - Khan, Uzma Rahim
A1  - Khan, Nadeem Ullah
A1  - Mushtaq, Saima
A1  - Rasul, Shahid
A1  - Hyder, Adnan A.
A1  - Razzak, Junaid
A1  - Haider, Adil H.
SP  - e001171
EP  - e001171
VL  - 8
IS  - 1
N2  - OBJECTIVES: A diverse set of trauma scoring systems are used globally to predict outcomes and benchmark trauma systems. There is a significant potential benefit of using these scores in low and middle-income countries (LMICs); however, its standardized use based on type of injury is still limited. Our objective is to compare trauma scoring systems between neurotrauma and polytrauma patients to identify the better predictor of mortality in low-resource settings. <br><br>METHODS: Data were extracted from a digital, multicenter trauma registry implemented in South Asia for a secondary analysis. Adult patients (≥18 years) presenting with a traumatic injury from December 2021 to December 2022 were included in this study. Injury Severity Score (ISS), Trauma and Injury Severity Score (TRISS), Revised Trauma Score (RTS), Mechanism/GCS/Age/Pressure score and GCS/Age/Pressure score were calculated for each patient to predict in-hospital mortality. We used receiver operating characteristic curves to derive sensitivity, specificity and area under the curve (AUC) for each score, including Glasgow Coma Scale (GCS). <br><br>RESULTS: The mean age of 2007 patients included in this study was 41.2±17.8 years, with 49.1% patients presenting with neurotrauma. The overall in-hospital mortality rate was 17.2%. GCS and RTS proved to be the best predictors of in-hospital mortality for neurotrauma (AUC: 0.885 and 0.874, respectively), while TRISS and ISS were better predictors for polytrauma patients (AUC: 0.729 and 0.722, respectively). <br><br>CONCLUSION: Trauma scoring systems show differing predictability for in-hospital mortality depending on the type of trauma. Therefore, it is vital to take into account the region of body injury for provision of quality trauma care. Furthermore, context-specific and injury-specific use of these scores in LMICs can enable strengthening of their trauma systems. LEVEL OF EVIDENCE: Level III.<p />  <p>Language: en</p>
LA  - en
SN  - 2397-5776
UR  - http://dx.doi.org/10.1136/tsaco-2023-001171
ID  - ref1
ER  -