Comparison of Blunt Abdominal Trauma Scoring System (BATSS) versus FAST in assessment of Blunt Trauma Abdomen

Trauma is the second largest cause of disease worldwide accounting for more than 16 % of global burden 1. By the next decade, the World Health Organization (WHO) estimates that trauma will be the leading cause of Years of Potential Life Lost (YPLL) amongst the world population. With advancement in infrastructure and economic prosperity, accidental trauma due to vehicular accidents has become more commonplace. A majority of victims of motor vehicular accidents present with Blunt abdominal trauma, which due to the complexity in diagnosis and management, presents with significant morbidity and mortality2. Introduced in the 1970s in Europe, point of care Ultrasonographic examination of the abdomen in trauma called as FAST (Focussed Assessment with Sonography for Trauma) has become a routine in emergency rooms worldwide 3. The Blunt Abdominal Trauma scoring system was developed to better diagnose intra-abdominal injury after blunt abdominal trauma 4. This study is aimed in comparing the findings of FAST and BATSS in predicting intra-abdominal injury accurately.

Can an App-Based Maxillofacial Trauma Score Predict the Operative Time, ICU Need and Length of Stay?

Study design Retrospective chart review Objective Injury and trauma scores are the mainstay of predicting outcomes of trauma patients. ZS (Zeeshan and Simon) maxillofacial trauma score is based on 4 previous facial trauma scores and is user friendly, app-based visually coded facial trauma scoring system. Our study was designed to seek the application of an app-based ZS maxillofacial trauma score to predict the operative time, intensive care unit (ICU) need and length of stay. Methods We performed a retrospective chart review of patients who presented to a university medical college teaching hospital with maxillofacial fractures from October 2018 until October 2019. ZS maxillofacial trauma scoring app was used to calculate the ZS maxillofacial trauma severity score, which was our primary predictor variable. Our primary outcome of interest was operative time. Our secondary outcome of interest was ICU need and length of stay. Correlation analysis, linear regression and logistic regression were performed for statistical analysis. A statistical P-value of .05 was considered significant at a 95% confidence interval. Results There were 95 male and 5 female patients included in the study. The age ranged from 3 to 84 years with a mean of 30.76 (SD = 14.04). A statistically significant correlation between the ZS score and operative time ( r = 0.67, P < .001) was observed. ZS score predicted operative time ( b 1 = 7.67, P < .001) in our study sample . Increasing ZS trauma score was also significantly associated with ICU requirement ( X 2(3) = 13.682, P = .003), but the length of stay could not be predicted based on ZS score. Conclusion: ZS maxillofacial trauma score can predict the operative time, and an association was seen with the need for ICU with increasing ZS score, but could not predict the length of stay or the ICU need. It has potential for future integration with electronic health record systems.

Comparison of Shiraz Trauma Transfusion Score (STTS) Potency With Common Scoring Systems for Trauma in Predicting the Short and Long Term Mortality of Injured Patients

Background and Objective: Trauma is the leading cause of death in people under 40 years of age worldwide. Various studies have been conducted focused on reducing the annual mortality rate due to trauma. One of the most important measures is reducing the time between the incident and the treatment set up, therefore the estimation of the severity of trauma and progressing to mortality before further evaluation is justified. In this study, we aim to compare different trauma scoring systems (such as GAP, MGAP, RTS, TRISS) with a relatively new model – Shiraz Trauma Transfusion Score (STTS) – and to describe the best qualities of these scoring systems for trauma patients in short (less than 24 hours) and long (more than 24 hours) term.Methods: In this cross-sectional study, data from hospitalized trauma patients in Rajaei hospital (center B) of Shiraz, Iran from May to November 2016 were collected and analyzed. Collected data consisted of age, sex, hospital admission duration, mechanism of trauma along with clinical data for calculating different trauma scoring systems, were recorded. Results: while RTS and STTS were the best predictors of mortality in trauma patients in the first 24 hours (sensitivity of 100.00%), GAP and MGAP were the best predictors of the patients’ survival (specificity of 93.83% and 92.59%). GAP and ISS were the best predictors of mortality in trauma patients for more than 24 hours (sensitivity of 82.02%). On the other hand, TRIS and RTS were the best predictors of patients' survival (specificity of 82.59% and 80.26%).Conclusions: Our study findings suggest that the utility and applicability of Shiraz Trauma Transfusion Score(STTS) in predicting mortality is not only comparable with other commonly used scoring methods but it may be of more value in shortterm mortality prediction.

Comparison of Shiraz Trauma Transfusion Score (STTS) Potency With Common Scoring Systems for Trauma in Predicting the Short and Long Term Mortality of Injured Patients

Background and Objective: Trauma is the leading cause of death in people under 40 years of age worldwide. Various studies have been conducted focused on reducing the annual mortality rate due to trauma. One of the most important measures is reducing the time between the incident and the treatment set up, therefore the estimation of the severity of trauma and progressing to mortality before further evaluation is justified. In this study, we aim to compare different trauma scoring systems (such as GAP, MGAP, RTS, TRISS) with a relatively new model – Shiraz Trauma Transfusion Score (STTS) – and to describe the best qualities of these scoring systems for trauma patients in short (less than 24 hours) and long (more than 24 hours) term.Methods: In this cross-sectional study, data from hospitalized trauma patients in Rajaei hospital (center B) of Shiraz, Iran from May to November 2016 were collected and analyzed. Collected data consisted of age, sex, hospital admission duration, mechanism of trauma along with clinical data for calculating different trauma scoring systems, were recorded. Results: while RTS and STTS were the best predictors of mortality in trauma patients in the first 24 hours (sensitivity of 100.00%), GAP and MGAP were the best predictors of the patients’ survival (specificity of 93.83% and 92.59%). GAP and ISS were the best predictors of mortality in trauma patients for more than 24 hours (sensitivity of 82.02%). On the other hand, TRIS and RTS were the best predictors of patients' survival (specificity of 82.59% and 80.26%).Conclusions: Our study findings suggest that the utility and applicability of Shiraz Trauma Transfusion Score(STTS) in predicting mortality is not only comparable with other commonly used scoring methods but it may be of more value in shortterm mortality prediction.

Incidence of Ocular, Adnexal and Orbital Trauma at Different Tertiary Care Centers of Karachi.

Purpose:To assess the incidence of ocular trauma resulting from various inciting agents presenting at three large centers of Karachi, Pakistan.Method:Patients with ocular trauma were recruited at the three centers over a period of three months, in this study. Any other ocular disease was excluded. After informed consent, history and examination was done. A proforma was filled for every patient. The various inciting agents were identified and incidence of the different types of ocular damage found. Trauma scoring was also done according to the Ocular Trauma Score.Results:A total of 343 patients with trauma presenting at different tertiary centres including DIMC 38 (11%), JPMC 150 (44%) and IPIO 155 (45%). Male predominance was found overall. Patients presented with different forms of injuries at the three centers. Commonest presentation at IPIO was of keratitis, at JPMC of road traffic accidents and at DIMC of corneal and conjunctival foreign body impaction. Most of the patients fell at grade 5 of Ocular Trauma Score.Conclusion:This study showed that the type of inciting agents were different at the three centers respective to their location, surrounding workplaces and the authority of the hospital to attend to medicolegal cases.

A Comparative Study Between Two Combat Injury Severity Scores

ABSTRACT Introduction In recent years, specific trauma scoring systems have been developed for military casualties. The objective of this study was to examine the discrepancies in severity scores of combat casualties between the Abbreviated Injury Scale 2005-Military (mAIS) and the Military Combat Injury Scale (MCIS) and a review of the current literature on the application of trauma scoring systems in the military setting. Methods A cross-sectional, descriptive, and retrospective study was conducted between May 1, 2005, and December 31, 2014. The study population consisted of all combat casualties attended in the Spanish Role 2 deployed in Herat (Afghanistan). We used the New Injury Severity Score (NISS) as reference score. Severity of each injury was calculated according to mAIS and MCIS, respectively. The severity of each casualty was calculated according to the NISS based on the mAIS (Military New Injury Severity Score—mNISS) and MCIS (Military Combat Injury Scale-New Injury Severity Score—MCIS-NISS). Casualty severity were grouped by severity levels (mild—scores: 1-8, moderate—scores: 9-15, severe—scores: 16-24, and critical—scores: 25-75). Results Nine hundred and eleven casualties were analyzed. Most were male (96.37%) with a median age of 27 years. Afghan patients comprised 71.13%. Air medevac was the main casualty transportation method (80.13). Explosion (64.76%) and gunshot wound (34.68%) mechanisms predominated. Overall mortality was 3.51%. Median mNISS and MCIS-NISS were similar in nonsurvivors (36 [IQR, 25-49] vs. [IQR, 25-48], respectively) but different in survivors, 9 (IQR, 4-17) vs. 5 (IQR, 2-13), respectively (P &lt; .0001). The mNISS and MCIS-NISS were discordant in 34.35% (n = 313). Among cases with discordant severity scores, the median difference between mNISS and MCIS-NISS was 9 (IQR, 4-16); range, 1 to 57. Conclusion Our study findings suggest that discrepancies in injury severity levels may be observed in one in three of the casualties when using mNISS and MCIS-NISS.

Comparison of Shiraz Trauma Transfusion Score (STTS) Potency With Common Scoring Systems for Trauma in Predicting the Short and Long Term Mortality of Injured Patients

Background: Trauma is the leading cause of death in people under 40 years of age worldwide. Various studies have been conducted focused on reducing the annual mortality rate due to trauma. One of the most important measures is reducing the time between the incident and the treatment set up, therefore estimation of the severity of trauma and progressing to mortality before further evaluation is justified. Numerous trauma scoring systems have been apllied worldwide as models for predicting mortality of trauma patients in short and long term periods based on clinical and laboratory data. In this study we aim to compare different trauma scoring systems (such as GAP, MGAP, RTS, TRISS) with a relatively new model – Shiraz Trauma Transfusion Score (STTS) – and to discribe the best qualities of these scoring systems for trauma patients in short (less than 24 hours) and long (more than 24 hours) term.Methods: In this cross-sectional study, data from hospitalized trauma patients in Rajaei hospital (center B) of Shiraz, Iran from May to November 2016 were collected and analyzed. Collected data consisted of age, sex, hospital admission duration, mechanism of trauma along with clinical data for calculating different trauma scoring systems, were recorded. Results: while RTS and STTS were the best predictors of mortality in trauma patients in the first 24 hours (sensitivity of 100.00%), GAP and MGAP were the best predictors of the patients’ survival (specificity of 93.83% and 92.59%). GAP and ISS were the best predictors of mortality in trauma patients for more than 24 hours (sensitivity of 82.02%). On the other hand, TRIS and RTS was the best predictors of patients' survival (specificity of 82.59% and 80.26%).Conclusions: Our study findings suggest that the utility and applicability of Shiraz Trauma Transfusion Score(STTS) in predicting mortality is not only comparable with other commonly used scoring methods but it may be of more value in short term mortality prediction.