Comparison of the predictive utility of Revised Trauma Score, Emergency Trauma Score, and Glasgow Coma Scale-Age-Pressure scores for emergency department mortality in multiple trauma patients

Abstract

Objective: In this study, we aimed to compare the utility of Revised Trauma Score (RTS), Glasgow Coma Scale, Age, and Systolic Blood Pressure (GAP) scores, and Emergency Trauma Score (EMTRAS) in multiple trauma patients for the prediction of mortality in the emergency department (ED). Materials and Methods: In this observational diagnostic accuracy study, a consecutive convenience sample of all adult patients (older than 16 years) with multiple trauma (injuries confined to at least two body regions) admitted to the trauma bay of the ED during the shifts of the researchers was used. Presence of ED mortality was recorded, and RTS, EMTRAS, and GAP scores were calculated at the analysis stage of this study. Results: The study sample included 279 multiple trauma patients. Of the 279 patients, 13 (4.7%) died in the ED. Among the 266 patients who survived to hospital admission, 3 were lost to-follow-up (foreigner patients). In the following 30 days, 28 more patients were lost, 23 in the Intensive Care Unit (ICU) (23/62, 37.1%), 4 in the wards (4/131, 3.1%), and 1 after discharge (1/73, 0.1%). The prognostic accuracies (AUC) of RTS, EMTRAS, and GAP were 0.92, 0.94, and 0.93, respectively, for ED mortality. Conclusion: In this study, all trauma scores performed similar in the ED for the prediction of ED mortality.