Clinical Investigation of Isolated Chest Injury

ABSTRACT

PURPOSE: Injuries are the third leading cause of death in Korea. Isolated chest injury is not uncommon and shows high mortality and morbidity. Several scoring systems are used for triage and stratification for trauma patients, but no standard system is accepted. We aimed to analyze the accuracy of identification of isolated chest injury by using several scoring systems. METHODS: We reviewed a total of 75 patients admitted with isolated chest injury between January 2005 and October 2005. Medical records were reviewed by using the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS). The scoring systems were compared by using statistics methods. RESULTS: The overall predictive accuracy of the TRISS was 12.5%, 12.0% greater than those of the RTS and the ISS. By using the area under the receiver operating characteristic (AUROC) curve, the TRISS showed an excellent discriminative power (AUROC 0.931) compared to the ISS (AUROC 0.926) and the RTS (AUROC 0.872). CONCLUSION: Compared with the RTS and the ISS, the TRISS is an easily applied tool with excellent prognostic abilities for isolated chest trauma patients. However, the TRISS, the ISS, and the RTS showed high specificity and low sensitivity, so another scoring system is required for triage and stratification of isolated chest injury patients.