Polytrauma: epidmiology and prognosis versus trauma score

ABSTRACT

To study the epidemiology of trauma and prognostic significance of various trauma score systems. A multi-center descriptive study. The study was conducted from July 1995 to March 2005 comprising almost 10 years in services hospitals of Lahore, Malir, Sialkot, and Mianwali. 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. 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. Revised Trauma Score [RTS] is useful t ool 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