Acil serviste abdominal travmal� hastalarda klinik sonu�lar�n bir g�stergesi olarak basitle�tirilmi� motor skor ile �arp�lm�� ters �ok indeksi: Retrospektif bir kohort �al��mas�

�irin, Ilker; Sanalp Menek�e, Tu�ba; Akkoca, Muzaffer

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Acil serviste abdominal travmal� hastalarda klinik sonu�lar�n bir g�stergesi olarak basitle�tirilmi� motor skor ile �arp�lm�� ters �ok indeksi: Retrospektif bir kohort �al��mas� [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2025; 31(4): 332-340 | DOI: 10.14744/tjtes.2025.23798

Acil serviste abdominal travmal� hastalarda klinik sonu�lar�n bir g�stergesi olarak basitle�tirilmi� motor skor ile �arp�lm�� ters �ok indeksi: Retrospektif bir kohort �al��mas�

Ilker �irin¹, Tu�ba Sanalp Menek�e¹, Muzaffer Akkoca²
¹Ankara Etlik �ehir Hastanesi, Acil T�p Klini�i, Ankara-T�rkiye
²Ankara Etlik �ehir Hastanesi, Genel Cerrahi Klini�i, Ankara-T�rkiye

AMA�: Bu �al��mada, abdominal travmal� hastalarda klinik sonu�lar�n bir �ng�r�c�s� olarak ters �ok indeksi (rSI) ile basitle�tirilmi� motor skor (sMS) �arp�m�n�n (rSIsMS) tan�sal de�erinin belirlenmesi ama�lanm��t�r.
GERE� VE Y�NTEM: �al��maya, 2023-2024 y�llar� aras�nda ��nc� basamak bir hastanenin acil servisine kar�n travmas� nedeniyle ba�vuran hastalar al�nd�. Hastalar�n verileri kullan�larak k�salt�lm�� yaralanma skalas� (AIS), yaralanma �iddet skoru (ISS), revize edilmi� travma skoru (RTS) ve travmaya ba�l� yaralanma �iddet skoru (TRISS) hesapland�. Ayr�ca, rSIsMS ile ters �ok indeksi ve Glasgow koma skalas� (GKS) �arp�m� olan rSIG hesapland�.
BULGULAR: �al��maya toplam 270 hasta al�nd�. Mortalite sonlan�m� a��s�ndan TRISS, rSIsMS ve rSIG�in tan�sal de�erlilikleri incelendi; s�ras�yla AUC de�erleri 0.928; 0.908 ve 0.886 olarak bulundu. Yo�un bak�m �nitesi (YB�) ihtiyac� i�in TRISS ve rSIsMS�in AUC de�erleri s�ras�yla 0.844 ve 0.852 olarak hesapland�. Cerrahi m�dahale ihtiyac� a��s�ndan TRISS ve rSIsMS�in AUC de�erleri s�ras�yla 0.774 ve 0.881 olup, bu sonlan�mda rSIsMS�nin tan�sal de�erlili�i TRISS�ten anlaml� d�zeyde y�ksekti (p<0.001; DeLong testi). Masif kan transf�zyonu (MKT) gereksinimi a��s�ndan TRISS ve rSIsMS�in AUC de�erleri s�ras�yla 0.799 ve 0.930 olarak bulundu. Bu sonlan�m i�in de rSIsMS�nin tan�sal de�erlili�i TRISS�ten anlaml� olarak y�ksekti (p<0.001; DeLong testi).
SONU�: rSIsMS, abdominal travmal� hastalarda masif kan transf�zyonu ve cerrahi m�dahale ihtiya�lar�n� �ng�rmede di�er travma skorlar�na g�re �st�nd�r ve mortalite ile YB� ihtiya�lar�n� �ng�rmede benzer performans g�stermektedir. Kolay hesaplanabilir olmas� ve yatak ba��nda h�zl�ca elde edilebilmesi, rSIsMS�nin acil servisteki klinik kullan�m de�erini art�rabilir.

Anahtar Kelimeler: Abdominal yaralanmalar, yaralanmalar, mortalite, travmatik �ok.

Reverse shock index multiplied by simplified motor score as an indicator of clinical outcomes in patients with abdominal trauma in the emergency department: a retrospective cohort study

Ilker �irin¹, Tu�ba Sanalp Menek�e¹, Muzaffer Akkoca²
¹Department of Emergency Medicine, Ankara Etlik City Hospital, Ankara-T�rkiye
²Department of General Surgery, Ankara Etlik City Hospital, Ankara-T�rkiye

BACKGROUND: This study aimed to determine the diagnostic value of the product of the reverse Shock Index (rSI) and the simplified Motor Score (sMS) (rSIsMS) as a predictor of clinical outcomes in patients with abdominal trauma.
METHODS: Patients who presented with abdominal trauma to the emergency department of a tertiary care hospital between 2023 and 2024 were included in the study. Using the patients� data, we calculated the Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS). Additionally, the rSIsMS and the product of the rSI and Glasgow Coma Scale (GCS) (rSIG) were calculated.
RESULTS: A total of 270 patients were included in the study. The diagnostic validity of the TRISS, rSIsMS, and rSIG, which had the highest area under the curve (AUC) values for mortality outcomes, was examined; the AUC values were 0.928, 0.908, and 0.886, respectively. The AUC values of the TRISS and rSIsMS concerning intensive care unit (ICU) needs were 0.844 and 0.852, respectively. With regard to surgical intervention needs, the AUC values of the TRISS and rSIsMS were 0.774 and 0.881, respectively. The diagnostic validity of the rSIsMS for surgical intervention needs was significantly higher than that of the TRISS (p<0.001, DeLong test). Concerning massive transfusion protocol (MTP) requirements, the AUC values of the TRISS and rSIsMS were 0.799 and 0.930, respectively. The diagnostic validity of the rSIsMS for MTP requirements was significantly higher than that of the TRISS (p<0.001, DeLong test).
CONCLUSION: The rSIsMS is superior to other trauma scores in predicting MTP and surgical intervention needs in patients with abdominal trauma, and it performs similarly to other trauma scores in predicting mortality and ICU needs. The ease of calculation and its ability to be obtained at the bedside may further enhance the clinical utility of the rSIsMS in the emergency department.

Keywords: Abdominal injuries, injuries, mortality, traumatic shock.

Sorumlu Yazar: Ilker �irin, T�rkiye
Makale Dili: �ngilizce

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