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Validation of the Thorax Trauma Severity Score for mortality and its value for the development of acute respiratory distress syndrome

Authors Aukema T, Beenen L, Hietbrink F, Leenen L 

Published 23 August 2011 Volume 2011:3 Pages 49—53


Review by Single anonymous peer review

Peer reviewer comments 2

Tjeerd S Aukema1, Ludo FM Beenen2, Falco Hietbrink1, Luke PH Leenen1
Department of Surgery, University Medical Center Utrecht, Utrecht, 2Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands

Background: The aim of the present study was to evaluate and to validate the Thorax Trauma Severity Score for mortality (TTSS).
Methods: By database analysis 712 patients with an injury to the chest admitted to the Universal Medical Center Utrecht between 2000 and 2004 were studied. All patients with a score of ≥1 on the AISthorax were included in the study. The patients' file was evaluated for: TTSS, intensive care unit stay, days on ventilation, thorax trauma-related complications (eg, acute respiratory distress syndrome [ARDS]), total hospital stay, and mortality.
Results: Of the 516 patients included in the study, 140 (27%) developed thorax-related complications. The overall in-hospital mortality rate was 10%. The receiver operating characteristic curve for predicting mortality demonstrated an adequate discrimination by a value of 0.844. The TTSS was statistically significant higher in patients who died of thorax-related complications than in patients who died because of nonthorax-related complications and survivors (P <0.001, confidence interval [CI] 95%). In patients who developed ARDS the TTSS was significant higher (P = 0.005, CI 95%).
Conclusion: This study supports the use of the TTSS for predicting mortality in thoracic injury patients. Furthermore, the TTSS appears capable of predicting ARDS.

Keywords: wounds and injuries, thorax, trauma severity indices, acute respiratory distress syndrome, mortality

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