创伤评分法应用评价

Evaluation of different trauma score systems

目的 探讨创伤评分法的有效应用 ,减少评分性误差。 方法 对随机选取的 185 5例创伤患者分为 3组 :门诊治疗组 5 83例、住院治疗组 90 7例及强化治疗组 36 5例。应用创伤记分(TS)、院前指数 (PHI)、格拉斯哥昏迷评分 (GCS)、损伤严重度评分 (ISS)、创伤与损伤严重度评分(TRISSRTS)、ASCOT法以及国际疾病分类损伤严重度评分 (ICISS)等常用的几种创伤评分法分别计量其损伤严重程度 ,并将各评分法实施结果加以比较分析。 结果 各创伤评分的接受器工作特性曲线下面积 (AUC)均在 0 .81～ 0 .91;特异性、敏感性及准确性达 78%以上 ;误分性和类选性指标显示 ,生理性指标多发生伤情判别过量、类选不足 ;解剖性指标则多出现伤情判别不足、类选过量 ;伤员预后仅靠生理、解剖或年龄等参数评估生存概率 (Ps)有可能存在较大的预测性误差。 结论创伤评分法应结合实际情况、具体伤情以及评分参数加以选择运用或完善评定。

Objective To investigate the effective application of trauma score methods and decrease the errors of evaluation. Methods The injury severity of 1 855 patients, including 583 outpatients, 907 inpatients, and 365 ICU patients, evaluated with various common -used trauma score methods was analyzed comparatively. Results The area under the receiver operating characteristics curves (AUC) of different trauma scoring methods were 0.81-0.91. Sp ecificity, sensitivity, and accuracy were above 78%. Excessiveness of scale in s everity and undertriage were found for physiological indexes; whereas insufficie ncy of scale in severity and overtriage for anatomic indexes. The errors may hap pen if the prognosis of trauma patients merely rely on physiological, anatomy or age parameters. Conclusions The use of different trauma score methods should be in combination with individual conditions and specific injury.