Injury Severity Scoring System for Trauma Patients and Trauma Outcomes Research in Korea

Introduction Trauma is one of the leading causes of mortality worldwide, but little is known of the temporal variation in major trauma across England, Wales and Northern Ireland. Proper workforce and infrastructure planning requires identification of the caseload burden and its temporal variation. Materials and Methods The Trauma Audit Research Network (TARN) database for admissions attending Major Trauma Centres (MTCs) between 1st April 2011 and 31st March 2018 was analysed. TARN records data on all trauma patients admitted to hospital who are alive at the time of admission to hospital. Major trauma was classified as an Injury Severity Score (ISS) >15. Results A total of 158,440 cases were analysed. Case ascertainment was over 95% for 2013 onwards. There was a statistically significant variation in caseload by year (p < 0.0001), times of admissions (p < 0.0001), caseload admitted during weekends vs weekdays, 53% vs 47% (p < 0.0001), caseload by season with most patients admitted during summer (p < 0.0001). The ISS varied by time of admission with most patients admitted between 1800 and 0559 (p < 0.0001), weekend vs weekday with more severely injured patients admitted during the weekend (p < 0.0001) and by season p < 0.0001). Discussion and Conclusion: There is a significant national temporal variation in major trauma workload. The reasons are complex and there are multiple theories and confounding factors to explain it. This is the largest dataset for hospitals submitting to TARN which can help guide workforce and resource allocation to further improve trauma outcomes.

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The Best Prediction Model for Trauma Outcomes of the Current Korean Population: a Comparative Study of Three Injury Severity Scoring Systems

Korean Journal of Critical Care Medicine ◽

10.4266/kjccm.2016.00486 ◽

2016 ◽

Vol 31 (3) ◽

pp. 221-228 ◽

Cited By ~ 4

Author(s):

Kyoungwon Jung ◽

John Cook-Jong Lee ◽

Rae Woong Park ◽

Dukyong Yoon ◽

Sungjae Jung ◽

...

Keyword(s):

Comparative Study ◽

Prediction Model ◽

Injury Severity ◽

Scoring Systems ◽

Korean Population ◽

Trauma Outcomes ◽

Severity Scoring

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Nighttime Trauma Fellow Care Is Associated with Improved Outcomes after Injury

The American Surgeon ◽

10.1177/000313481808400319 ◽

2018 ◽

Vol 84 (3) ◽

pp. 365-370 ◽

Cited By ~ 2

Author(s):

Jessica H. Beard ◽

Niels D. Martin ◽

Patrick M. Reilly ◽

Mark J. Seamon

Keyword(s):

Injury Severity ◽

Primary Study ◽

Trauma Patients ◽

Trauma Surgeon ◽

Trauma Outcomes ◽

Delay In Diagnosis ◽

Admission Time ◽

Missed Injury ◽

Improved Outcomes ◽

Surgeon Experience

Time of admission and surgeon experience may explain variations in trauma outcomes. We hypothesized that earlier admission time by a more experienced trauma surgeon leads to improved outcomes after injury. We conducted a retrospective cohort study using trauma registry and performance improvement data at our Level 1 trauma center. Consecutive patients presenting at night from 2013 to 2014 were dichotomized into early (6:00 PM–12:00 AM) and late (12:01 AM–7:00 AM) cohorts. Second year trauma fellows acting as attendings and staff trauma surgeons were categorized as less and more experienced, respectively. The primary study outcome was any complication tracked by our state registry, missed injury, delay in diagnosis, or death. The influence of admission time and trauma surgeon experience on this endpoint was examined using multivariable logistic regression. A total of 2078 patients presented either during early (n = 1189) or late (n = 889) night. The cohorts were not different with respect to Deyo–Charlson index, systolic blood pressure, Glasgow Coma Scale, Injury Severity Core, admitting trauma surgeon age, experience, or unadjusted primary study outcome (early 14 vs late 16%; P = 0.206). Trauma surgeon experience was independently predictive of outcomes. Trauma patients admitted at night by fellows were 29 per cent less likely to sustain complications or death than those admitted by staff (adjusted odds ratio 0.71; 95% confidence interval: 0.54–0.92, P = 0.010). This protective effect of fellow care was found only in patients admitted after midnight ( P = 0.03). In conclusion, nighttime initial trauma care by fellows was associated with improved outcomes. Possible explanations include more oversight of nighttime fellow care, variations in daytime responsibilities between fellows and staff, and differential effects of sleep loss by age.

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Prediction of hand strength by hand injury severity scoring system in hand injured patients

Disability and Rehabilitation ◽

10.3109/09638288.2011.607550 ◽

2011 ◽

Vol 34 (5) ◽

pp. 423-428 ◽

Cited By ~ 4

Author(s):

Delmar C.Y. Lin ◽

Jer-Hao Chang ◽

Shyh-Jou Shieh ◽

Feruth H.J. Tsai ◽

Yungling Leo Lee

Keyword(s):

Scoring System ◽

Injury Severity ◽

Hand Injury ◽

Hand Strength ◽

Severity Scoring ◽

Injured Patients

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Trauma Embolic Scoring System in military trauma: a sensitive predictor of venous thromboembolism

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2019-000367 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000367 ◽

Cited By ~ 1

Author(s):

Patrick F Walker ◽

Seth Schobel ◽

Joseph D Caruso ◽

Carlos J Rodriguez ◽

Matthew J Bradley ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

High Risk ◽

Scoring System ◽

Injury Severity ◽

Univariate Analysis ◽

Trauma Patients ◽

Military Trauma ◽

Support Tools ◽

Combat Casualties

IntroductionClinical decision support tools capable of predicting which patients are at highest risk for venous thromboembolism (VTE) can assist in guiding surveillance and prophylaxis decisions. The Trauma Embolic Scoring System (TESS) has been shown to model VTE risk in civilian trauma patients. No such support tools have yet been described in combat casualties, who have a high incidence of VTE. The purpose of this study was to evaluate the utility of TESS in predicting VTE in military trauma patients.MethodsA retrospective cohort study of 549 combat casualties from October 2010 to November 2012 admitted to a military treatment facility in the USA was performed. TESS scores were calculated through data obtained from the Department of Defense Trauma Registry and chart reviews. Univariate analysis and multivariate logistic regression were performed to evaluate risk factors for VTE. Receiver operating characteristic (ROC) curve analysis of TESS in military trauma patients was also performed.ResultsThe incidence of VTE was 21.7% (119/549). The median TESS for patients without VTE was 8 (IQR 4–9), and the median TESS for those with VTE was 10 (IQR 9–11). On multivariate analysis, Injury Severity Score (ISS) (OR 1.03, p=0.007), ventilator days (OR 1.05, p=0.02), and administration of tranexamic acid (TXA) (OR 1.89, p=0.03) were found to be independent risk factors for development of VTE. On ROC analysis, an optimal high-risk cut-off value for TESS was ≥7 with a sensitivity of 0.92 and a specificity of 0.53 (area under the curve 0.76, 95% CI 0.72 to 0.80, p<0.0001).ConclusionsWhen used to predict VTE in military trauma, TESS shows moderate discrimination and is well calibrated. An optimal high-risk cut-off value of ≥7 demonstrates high sensitivity in predicting VTE. In addition to ISS and ventilator days, TXA administration is an independent risk factor for VTE development.Level of evidenceLevel III.

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Inhalation Injury Severity Scoring System A Quantitative Method

Journal of Burn Care & Rehabilitation ◽

10.1097/00004630-199611000-00013 ◽

1996 ◽

Vol 17 (6) ◽

pp. 552-557 ◽

Cited By ~ 34

Author(s):

David L. Brown ◽

Stephen B. Archer ◽

David G. Greenhalgh ◽

Mark A. Washam ◽

Laura E. James ◽

...

Keyword(s):

Scoring System ◽

Quantitative Method ◽

Injury Severity ◽

Inhalation Injury ◽

Severity Scoring ◽

System A

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Evaluation of Facial Trauma Severity in Cipto Mangunkusumo Hospital Using FISS Scoring System

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i2.45 ◽

1970 ◽

Vol 1 (2) ◽

Author(s):

Kristaninta Bangun ◽

Ayu Diah Kesuma

Keyword(s):

Injury Severity Score ◽

Severity Score ◽

Scoring System ◽

Injury Severity ◽

Scoring Systems ◽

Facial Trauma ◽

Trauma Patients ◽

Documentation System ◽

Trauma Severity ◽

Degree Of Severity

Many scoring systems were introduced to search prognostic value in trauma patients. Facial trauma is a special trauma because it can cause many disabilities in facial function. There have been several reports on facial severity scoring system, such as Facial Injury Severity Score (FISS) and Maxillofacial Injury Severity Score (MFISS). Although these scoring systems have been introduced in many journals, they are not yet used by many clinicians because of their unawareness of its beneficiary. In this study, we want to introduce and apply these scoring systems in our maxillofacial data, thus it can be used for documentation system, as a research tool, and have prediction value for prognosis We retrospectively collected data on patients with facial trauma in Cipto Mangunkusumo Hospital in 2009. The data collected were age, gender, etiology, use of helmet, type of fracture and treatment given. Each patient then evaluated by FISS score to obtain their degree of severity. Using FISS score introduced by Bagheri, we found the average FISS score ini this evaluation was 3,37 ± 1,9, with minimum value 1 and maximum value 9. Most patients have FISS score 2 (24,7%). From FISS scoring system, we found that most of maxillofacial trauma in Cipto Mangunkusumo hospital in 2009 was mild trauma. In order to evaluate if FISS scoring system has predictive value for prognosis, a large sample and complete maxillofacial database are needed.

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The Hand Injury Severity Scoring System

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(05)80187-1 ◽

1996 ◽

Vol 21 (3) ◽

pp. 295-298 ◽

Cited By ~ 91

Author(s):

D. A. Campbell ◽

S. P. J. Kay

Keyword(s):

Retrospective Study ◽

Injury Severity Score ◽

Return To Work ◽

Severity Score ◽

Scoring System ◽

Injury Severity ◽

Hand Injury ◽

Weighting Factor ◽

The Other ◽

Severity Scoring

A descriptive severity scoring system for injuries to the hand, distal to the carpus, has been designed. Each ray of the hand is assessed separately. Each ray’s score is then multiplied by a weighting factor for that ray and added to the scores of the other rays to obtain a total score for the injury. This system has been tested on a series of specimen injuries and compared with the opinion of experienced hand surgeons. A retrospective study of hand injuries has also been conducted, and the Hand Injury Severity Score (HISS) has been found to closely correlate with return to work. Four grades of increasing severity of hand injury have been described. Although this system has been designed as a research tool, it is envisaged that it would be a useful immediate measure of severity and a guide to likely outcome.

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