Background
As accurate assessment of thoracic injury severity in the early phase after trauma
is difficult, we compared different thoracic trauma scores regarding their predictive
ability for the development of post-traumatic complications and mortality.
Materials and Methods
Two hundred seventy-eight multiple trauma patients (ISS ≥ 16) age > 16 y with severe
blunt chest trauma (AISchest ≥ 3) admitted between 2000 and 2009 to Level I Trauma center were included. Exclusion
criteria were severe traumatic brain injury (AIShead ≥ 3) and penetrating thoracic trauma. The association between AISchest, Pulmonary Contusion score (PCS), Wagner-score and Thoracic Trauma Severity score
(TTS), and duration of ventilation, length of ICU stay, development of post-traumatic
complications, and mortality was investigated. Statistical analysis was performed
with χ2-test, ANOVA, logistic regression, and receiver operating characteristic (ROC) curve.
Results
Patients’ mean age was 42.7 ± 17.0 y, the mean injury severity score was 28.7 ± 9.3
points. Overall, 60 patients (21.6%) developed ARDS, 143 patients (51.4%) SIRS, 110
patients (39.6%) sepsis, and 36 patients (13.0%) MODS. Twenty-two patients (7.9%)
died. Among the examined thoracic trauma scores only the TTS was an independent predictor
of mortality. With the TTS showing the best prediction power, the TTS, PCS, and Wagner-score
were independent predictors of ventilation time, length of ICU stay, and the development
of post-traumatic ARDS and MODS.
Conclusions
Thoracic trauma scores combining anatomical and physiologic parameters like the TTS
seem to be most suitable for severity assessment and prediction of outcome in multiple
trauma patients with concomitant blunt chest trauma.
Key Words
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Article info
Publication history
Published online: October 05, 2011
Accepted:
September 9,
2011
Received:
June 19,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
