Ulus Travma Acil Cerrahi Derg. 2009; 15(6): 559-564

Comparison of trauma scoring systems for predicting mortality in firearm injuries

Özlem Köksal¹, Fatma Özdemir¹, Mehtap Bulut¹, Þule Aydýn¹, Meral Leman Almacýoðlu¹, Halil Özgüç^2
1Department Of Emergency Medicine, Uludag University, Bursa, Turkey
²Department Of General Surgery, Uludag University, Bursa, Turkey

BACKGROUND
Prediction of mortality in trauma patients is an important part of trauma care. Trauma scoring systems are the current methods used for prediction of mortality. We aimed to evaluate and compare the performances of Injury Severity Score (ISS) and New Injury Severity Score (NISS) in firearm injuries.
METHODS
Records of 135 firearm-injured patients who applied to Uludag University Emergency Department between January 2001 and December 2005 were analyzed retrospectively. All patients’ data, including age, gender, cause of injury, initial vital signs, injury region, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), mortality, operation data, and final diagnosis, were collected, and ISS, NISS and Trauma and Injury Severity Score (TRISS) were calculated.
RESULTS
Mortality rate was 12.6%. The patients’ mean GCS, RTS, ISS, NISS, and TRISS scores were 13.41±0.31, 10.65±0.26, 17.04±1.20, 21.94±1.45, and 9.52±2.37, respectively. The patients were divided into two groups as ISS=NISS (53.3%) and ISSCONCLUSION
ISS and NISS both performed well in mortality prediction of firearm injuries. NISS demonstrated no superiority to ISS for prediction of mortality in these patients.

Keywords: Injury Severity Score, New Injury Severity Score; firearm injury; prediction of mortality.

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Ateþli silah yaralanmalý olgularda mortalite belirlenmesinde skorlama sistemlerinin karþýlaþtýrýlmasý

Özlem Köksal¹, Fatma Özdemir¹, Mehtap Bulut¹, Þule Aydýn¹, Meral Leman Almacýoðlu¹, Halil Özgüç^2
1Uludað Üniversitesi Týp Fakültesi, Acil Týp Ana Bilim Dalý, Bursa
²Uludað Üniversitesi Týp Fakültesi, Genel Cerrahi Ana Bilim Dalý, Bursa

AMAÇ
Travma hastalarýnda mortalitenin öngörülmesi travma bakýmýnýn önemli bir parçasýdýr. Günümüzde bu amaçla travma skorlama sistemleri yaygýn olarak kullanýlmaktadýr. Bu çalýþmada, ateþli silah yaralanmasý olan hastalarda yaralanma þiddeti ölçeði (ISS) ve yeni yaralanma þiddeti ölçeði’nin (NISS) mortaliteyi belirlemedeki performanslarýnýn deðerlendirilmesi ve karþýlaþtýrýlmasý amaçlandý.
GEREÇ VE YÖNTEM
Uludað Üniversitesi Hastanesi Acil Servisine Ocak 2001-Aralýk 2005 tarihleri arasýnda baþvuran, 135 ateþli silah yaralanmalý olgunun kayýtlarý geriye dönük olarak incelendi. Tüm hastalarýn yaþ, cinsiyet, oluþ þekli, baþvuru anýndaki vital bulgularý, yaralanma bölgeleri, Glasgow koma skalasý (GCS) ve revize travma skoru (RTS), mortalite, operasyon bilgileri ve kesin tanýlarý kaydedildi ve ISS, NISS ve TRISS skorlarý hesaplandý.
BULGULAR
Mortalite oraný %12,6 idi. Hastalarýn GCS, RTS, ISS, NISS ve TRISS skorlarý sýrasýyla; 13,41±0,31, 10,65±0,26, 17,04±1,20, 21,94±1,45, 9,52±2,37 olarak saptandý. Hastalar ISS=NISS (%53,3) ve ISSSONUÇ
Her iki skorlama sistemi de ateþli silah yaralanmalý hastalarda mortaliteyi öngörmedeki performansý iyidir ve bu hastalarda mortaliteyi belirlemede NISS’nin ISS’ye üstün olmadýðý sonucuna varýlmýþtýr.

Anahtar Kelimeler: ISS, NISS, ateþli silah yaralanmasý, mortalitenin öngörülmesi.

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