prognostic value of trauma scoring systems for gunshot injuries

ABSTRACT

We aimed to evaluate the trauma scoring systems on gunshot injured patients to predict trauma severity. All patients with gunshot injury admitted to the emergency department [ED] from January 2007 through January 2009 were enrolled in the study. The demographic characteristics of patients such as age, gender, cause of the injury, type of the weapon used, the injured body parts, Glasgow Coma Scale [GCS], Shock Index [SI], the length of stay in the hospital and mortality were recorded from the patient charts. Injury Severity Score [ISS], Revised Trauma Score [RTS] and Trauma and Injury Severity Score [TRISS] have been calculated. The differences between the groups for these parameters were compared using the Mann-Whitney U test. The mean age of patients was 33.2 +/- 16.1 and 79 of 87 patients were male. The causes of GSIs were homicidal in 73.6% and bullet cartridge in 51.7%. Calculated GCS, ISS, RTS, TRISS and SI were 13.8 +/- 2.9, 13.0 +/- 9.3, 7.38 +/- 1.1, 93.9 +/- 14.9% and 1.9 +/- 0.9 respectively. GCS, RTS and TRISS scores for survivors were significantly higher than non-survivors [p<0.001]. ISS score and SI for survivors were significantly lower than non-survivors [p<0.001]. There were no statistically significant differences between the groups in terms of the length of stay in hospital [p>0.05]. There was no statistically significant correlation of the length of stay in hospital with GCS, RTS and TRISS [p>0.05]. The length of stay in hospital was found to correlate with ISS and SI positively [p<0.001]. It is concluded that Gun Shot Injury [GSI] is much more likely in young males than the other types of trauma in the population. We recommend that trauma scoring systems should be used to show trauma severity and mortality