مروری بر سیستم های نمره دهی پیش بینی کننده مرگ و میر تروما در ایران

نوع مقاله : مقاله مروری

نویسندگان

1 دانشیار گروه فناوری اطلاعات سلامت، دانشکده علوم پیراپزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

2 ‏دانشیار گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

3 ‏استادیار گروه انفورماتیک پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران‏

4 کارشناسی ارشد فناوری اطلاعات سلامت، گروه فناوری اطلاعات سلامت، دانشکده علوم پیراپزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

5 استادیار گروه فناوری اطلاعات سلامت، دانشکده علوم پیراپزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

6 کارشناس مدارک پزشکی ، بیمارستان طالقانی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

7 کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

هدف:
ارزیابی شدت تروما یک مقیاس کمی قابل اندازه گیری می ‌باشد. از چندین سال پیش، مقیاس ‌های مختلفی برای تعیین شدت تروما در بیماران ترومایی به کار گرفته شده است. بررسی و پیش بینی سریع شدت تروما، تعیین پیش آگهی میزان مرگ و میر و بقای احتمالی موجب ارائه درمان بهنگام و بهتر می‌گردد. لذا این مطالعه با هدف مروری بر مطالعات انجام شده در ارتباط با مقایسه  سیستم های مختلف نمره دهی جهت پیش بینی مرگ و میر تروما در ایران انجام گردید.
روش بررسی:
در مطالعه حاضر از دستورالعمل پریزما؛ ﻣﻮارد ﺗﺮﺟﯿﺤﯽ در ﮔﺰارش ﻣﻘﺎﻻت ﻣﺮوری ﻣﻨﻈﻢ و ﻓﺮاﺗﺤﻠﯿﻞ ﻫﺎ به منظور بررسی مطالعات استفاده شد. برای این منظور، پایگاه‌ های اطلاعاتی PubMed Scopus,، مگیران و پایگاه اطلاعات علمی جهاد دانشگاهی برای بازیابی مقالات انگلیسی و فارسی مورد جستجو قرارگرفتند. جستجوها بدون محدودیت زمانی و تا21 فوریه 2023 انجام شدند. مطالعات منتشر شده که به مقایسه بین سیستم های نمره دهی جهت بررسی شدت تروما انجام شده بودند، به مطالعه وارد و ویژگی ‌های آن ها مورد بررسی قرار گرفتند. تجزیه و تحلیل داده‌ ها از طریق روش تحلیل محتوا انجام شد.
یافته ها:
تعداد 663 مطالعه بازیابی شدند که پس از حذف موارد تکراری و نامرتبط بر اساس ارزیابی عنوان، چکیده و متن کامل در نهایت 32 مطالعه وارد مرور شدند. در 15/62 درصد مطالعات انجام شده شاخص نمره دهی شدت آسیب و تروما جهت ارزیابی شدت تروما پیشنهاد گردیده است. سیستم های نمره دهی آپاچی (9/37)، مقیاس کمای گلاسکو (9/37)، امتیاز شدت آسیب (6/25) درصد .
نتیجه گیری :
طبق بررسی حاضر شاخص (Trauma and Injury Severity Score;TRISS) نمره دهی شدت آسیب و تروما جهت استفاده در ایران پیشنهاد می‌گردد. استفاده از این معیارکمی، می ‌تواند در پیش بینی مرگ و میر و ارزیابی برنامه ‌های ارایه شده جهت کیفیت خدمات مورد استفاده قرارگیرد. جهت جلوگیری از هرگونه خطای احتمالی بهتر است شاخص ‌های دیگری همچون  امتیاز شدت آسیب و ( MGAP;Mechanism, Glasgow Coma Scale, Age and Arterial Pressure) به همراه این شاخص محاسبه گردد.

کلیدواژه‌ها


  1. Soltani Y, Khaleghdoost Mohamadi T, Adib M, et al. Comparing the Predictive Ability for Mortality Rates by GAP and MGAP Scoring Systems in Multiple-Trauma Patients. J Mazandaran Univ Med Sci 2018; 27(157): 118-132.
  2. Kashefi P, Saghaeim M, Dehghani-Meibodi D. Comparison of Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II Scoring Systems on Detection Prognosis of Mortality in Patients with Trauma Admitted to the Intensive Care Unit.J Isfahan Med Sch 2018; 36 (478): 460-465.
  3. World report on road traffic injury prevention.WHO. Available at: https://www.who.int/publications-detail-redirect/world-report-on-road-traffic-injury prevention.2023.
  4. Garkaz O, Salari Lak Sh, Mehryar H.R, Khalkhali H.R. Determining Survival Rate of Traffic Accident Victims and Assessing the Quality of Hospital Care in Imam Khomeini Hospital, Urmia by Using TRISS Method. Iranian Journal of Forensic Medicine 2019; 25(1): 23-29.
  5. Chen SS1, Bosson N, Gausche-Hill M, Gorospe DD, et al. The Evolution of Trauma in Los Angeles County Over More Than a Decade.J Public Health Manag Pract 2019; 25(1): 17-20.
  6. Aghakhani K, Eslami S H, Khara A, Bijandi M. Epidemiologic study of fall-related head injury in Iran and its comparison with other countries: review article. Tehran Univ Med J 2018; 76(7): 437-445.
  7. Mobaleghi J, Yaghoobi Notash A, Yaghoobi Notash A, Ahmadi Amoli H, et al. Evaluation of trauma patterns and their related factors in Besat Hospital in Sanandaj in 2012. SJKU 2014; 19(1): 99-107.
  8. Ebrahimi H, Abbasi A, Hoseini A, Shamsizadeh M, et al. Comparison of patient’s prognostic based on Madras Head Injury Prognostic Scale and Glasgow Outcome Scale in head trauma patients admitted in emergency ward of 5th Azar educative and therapeutic center in Gorgan, 2011.Journal of Clinical Nursing and Midwifery 2016; 4(4): 68-79.
  9. Zamani M, Esmailian M, Mirazimi MS, Ebrahimian M, Golshani K Cause and Final Outcome of Trauma  in Patients Referred to the Emergency Department; a Cross Sectional Study.Iranian Journal of Emergency Medicine 2014; 1(1): 22-27.
  10. Moradi Lakeh M, Tehrani Banihashemi S, Varasteh Kia G, Roohipour M. Comparison of Trauma Scoring Systems for Prediction of Patients’ Prognosis. Rjms 2002; 9(28): 129-137.
  11. Champion HR, Sacco WJ, Copes WS, Gann DS, et al. A revision of the Trauma Score. J Trauma 1989; 29(5): 623-629.
  12. Kuo SCH, Kuo PJ, Chen YC, Chien PC, et al. Comparison of the new Exponential Injury Severity Score with the Injury Severity Score and the New Injury Severity Score in trauma patients: A cross-sectional study. PLoS One 2017; 12(11): 1-12.
  13. Jiefu Lu, Ronglin Chen, Liqun Tang, Huimei Yin, et al. Comparison of the prognostic effects of APACHEII score and the TRISS for geriatric trauma patients in the intensive care unit. Int J Clin Exp Med 2018; 11(9): 9646-9653.
  14. Kramer AA, Sebat F, Lissauer M. A Review of Early Warning Systems for Prompt Detection of Patients at Risk for Clinical Decline.  J Trauma Acute Care Surg 2019; 87 (1): 67-73.
  15. Chow J, Kuza CM. Predicting mortality in elderly trauma patients: a review of the current literature. Current opinion in anaesthesiology 2022; 35(2): 160-165.
  16. Ghaffarzad A, Vahed N, Vahdati SS, Ala A, Jalali M. The accuracy of rapid emergency medicine score in predicting mortality in non-surgical patients: A systematic review and meta-analysis. Iranian Journal of Medical Sciences 2022; 47(2): 83.
  17. Manoochehry S, Vafabin M, Bitaraf S, Amiri A. A Comparison between the Ability of Revised Trauma Score and Kampala Trauma Score in Predicting Mortality; a Meta-Analysis. Arch Acad Emerg Med 2019; 7(1): e6.
  18. Page MJ, Mc-Kenzie JE, Bossuyt PM, Boutron I, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021; 88(1): 105906.
  19. Shahla A. Multiple Trauma Items Scoring in the university of urmia university of medical sciences per year 2005. Medical Journal of urmia 2007; 18(4): 665-669.
  20. Amini Sh, Safari Malekabadi M, Roudbari M, Comparison of APACHE II, Adjusted APACHE II and TRISS Scores in Predicting Mortality Rate in Head Trauma Patients Admitted to ICU at Khatam-al-Anbia Hospital of Zahedan.Tabib Shargh 2009; 11(3): 25-31.
  21. Yousefifard M, Shahsavarinia K, Faridaalee GH, Dinpanah H, et al. Comparison of Glasgow Coma Scale with Physiologic Scoring Scales in Prediction of In-Hospital Outcome of Trauma Patients; a Diagnostic Accuracy Study. Front Emerg Med. 2020; 4(4): e89.
  22. Akhavan Akbari G, Mohammadian A. Comparison of the RTS and ISS Scores on Prediction of Survival Chances in Multiple Trauma Patients. Acta Chir Orthop Traumatol Cech. 2012; 79(6): 535-539.
  23. Morteza Bagi H, Ahmadi S, Hossein M. Demographics of Fall-Related trauma among the Elderly Presenting to Emergency Department; a Cross-Sectional Study. Emerg (Tehran). 2017; 5(1): e78.
  24. Yadollahi M, Jamali B. Severity and injury characteristics among matched hospitalized motorcycle drivers and their passengers. Chin J Traumatol 2019; 22: 223-227.
  25. Yadollahi M, Ghaedsharaf Z, Jamali K, Niakan MH, et al. The Accuracy of GAP and MGAP Scoring Systems in Predicting Mortality in Trauma; a Diagnostic Accuracy Study. Adv J Emerg Med 2020; 4(3): e73.
  26. Habibpour HR, Torabi M, Mirzaee M. The Value of Red Cell Distribution Width (RDW) and Trauma-Associated Severe Hemorrhage (TASH) in Predicting Hospital Mortality in Multiple Trauma Patients. Bull Emerg Trauma 2019; 7(1): 55-59.
  27. Nakhjavan-Shahraki B, Yousefifard M, Hajighanbari M, Karimi P, et al. Worthing Physiological Score Vs Revised Trauma Score in Outcome Prediction of Trauma patients; a Comparative Study. Emergency 2017; 5(1): 1-7.
  28. Yadollahi M, Kashkooe A, Rezaiee R, Jamali K, Niakan M.H. A Comparative Study of Injury Severity Scales as Predictors of Mortality in Trauma Patients: Which Scale Is the Best?. Bull Emerg Trauma 2020; 8(1): 27-33.
  29. Garkaz O, Mehryar HR, Khalkhali HR, Lak SS. A comparative study on the ability of Trauma in determining the prognosis of patients having accident and referred to Imam Khomeini Hospital of Urmia in 2016. Arch Trauma Res 2020; 9(2): 62-68.
  30. Salehi O, Tabibzadeh Dezfuli S.A, Namazi S.SH, Dehghan Khalili M, et al. A New Injury Severity Score for Predicting the Length of Hospital Stay in Multiple Trauma Patients. Trauma Mon 2016; 21(1): 1-5.
  31. Darbandsar Mazandarani P, Heydari K, Hatamabadi H, Kashani P, et al. Acute Physiology and Chronic Health Evaluation (APACHE) III Score com-pared to Trauma-Injury Severity Score (TRISS) in Predicting Mortality of Trauma Patients. Emerg (Tehran) 2016; 4 (2): 88-91.
  32. Rabbani A, Moini M, Application of “Trauma and Injury Severity Score” and “A Severity Characterization of Trauma” Score to Trauma Patients in A Setting Different from “Major Trauma Outcome Study”. Arch Iranian Med 2007; 10 (3): 383-386.
  33. Norouzi V, Feizi I, Vatankhah S, Pourshaikhian M. Calculation of the probability of survival for trauma patients based on trauma score and the injury severity score model in fatemi hospital in ardabil. Arch Trauma Res 2013; 2(1): 30-35.
  34. Rahmani F, Ebrahimi Bakhtavar H, Shams Vahdati S, Hosseini M, et al. Evaluation of MGAP and GAP Trauma Scores to Predict Prognosis of Multiple-trauma Patients.Trauma Mon 2017; 22(3): 1-6.
  35. Khormali M, Payandemehr P, Zafarmandi S, Baigi V, et al. Predictive Utility of the Glasgow Coma Scale and the Head Abbreviated Injury Scale in Traumatic Brain Injury: Results from the National Trauma Registry of Iran. Arch Iran Med 2022; 25(8): 496-501.
  36. Khari S, Zandi M, Yousefifard M. Glasgow Coma Scale Versus Physiologic Scoring Systems in Predicting the Outcome of ICU admitted Trauma Patients; a Diagnostic Accuracy Study. Arch Acad Emerg Med 2022; 10(1): e25.
  37. Khafafi B, Garkaz O, Golfiroozi S, Paryab S, et al. Comparison the Ability of Quantitative Trauma Severity Assessment Methods Based On GAP, RTS, and ISS Criteria in Determining the Prognosis of Accidental Patients. Bull Emerg Trauma 2022; 10(3): 122-127.
  38. Farzan N, Foroghi Ghomi SY, Mohammadi AR. A retrospective study on evaluating GAP, MGAP, RTS and ISS trauma scoring system for the prediction of mortality among multiple trauma patients.  Ann Med Surg (Lond) 2022; 76: 103536.
  39. Rahmatinejad Z, Tohidinezhad F, Rahmatinejad F, Eslami S, et al. Internal validation and comparison of the prognostic performance of models based on six emergency scoring systems to predict in-hospital mortality in the emergency department. BMC Emerg Med 2021; 21(1): 68.
  40. Heydari F, Azizkhani R, Ahmadi O, Majidinejad S, et al. Physiologic Scoring Systems versus Glasgow Coma Scale in Predicting In-Hospital Mortality of Trauma Patients; a Diagnostic Accuracy Study. Arch Acad Emerg Med 2021; 9(1): e64.
  41. Kashefi P, Abbasian Z, Abbasi S, Saghaei M. Comparison of the accuracy of two methods on detection of the prognosis of mortality in patients with trauma admitted to the intensive care units of Alzahra hospital, Isfahan, Iran, in 2015. J Isfahan Med Sch 2018; 35(455): 1620-1625.
  42. Ghelichkhani P, Esmaeili M, Hosseini M, Seylani K. Glasgow Coma Scale and FOUR Score in Predicting the Mortality of Trauma Patients; a Diagnostic Accuracy Study. Emerg (Tehran) 2018; 6(1): e42.
  43. Nakhjavan-Shahraki B, Yousefifard M, Faridaalaee G, Shahsavari K, et al. Performance of physiology scoring systems in prediction of in-hospital mortality of traumatic children: A prospective observational study. J Clin Orthop Trauma 2017; 8(Suppl 2): 43-48.
  44. Nakhjavan-Shahraki B, Baikpour M, Yousefifard M, Nikseresht ZS, et al. Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study. Emerg (Tehran) 2017; 5(1): e30.
  45. Yousefzadeh-Chabok S, Hosseinpour M, Kouchakinejad-Eramsadati L, Ranjbar F, et al. Comparison of Revised Trauma Score, Injury Severity Score and Trauma and Injury Severity Score for mortality prediction in elderly trauma patients. Ulus Travma Acil Cerrahi Derg 2016; 22(6): 536-540.
  46. Zali AR, Seddighi AS, Seddighi A, Ashrafi F. Comparison of the acute physiology and chronic health evaluation score (APACHE) II with GCS in predicting hospital mortality of neurosurgical intensive care unit patients. Glob J Health Sci 2012; 4(3): 179-184.
  47. Kyoungwon J, Yo H, John Cook-Jong Lee, Younghwan K, et al. The Applicability of Trauma and Injury Severity Score for a Blunt Trauma Population in Korea and a Proposal of New Models Using Score Predictors. YMJ 2016; 57(3): 728-734.
  48. Khosravi A, Ebrahimi H. To Evaluate the Outcomes of Patients with Truma Admitted to the Imam Hossein Hospital, Shahrood Using the Trauma and Injury Severity Score (TRISS). irje 2008; 4(2): 35-41.
  49. Höke MH, Usul E, Özkan S. Comparison of Trauma Severity Scores (ISS, NISS, RTS, BIG Score, and TRISS) in Multiple Trauma Patients. J Trauma Nurs 2021; 28(2): 100-106.
  50. Larkin EJ, Jones MK, Young SD, Young JS. Interest of the MGAP score on in-hospital trauma patients: Comparison with TRISS, ISS and NISS scores. Injury 2022; 53(9): 3059-3064.
  51. Salehi S H, Razmjoo I. Prognosis assessment of The Injury Severity Score in traffic accidents. Iran South Med J 2006; 9(1): 45-50.
  52. Chiang YT, Lin TH, Hu RH, Lee PC, et al. Predicting factors for major trauma patient mortality analyzed from trauma registry system. Asian J Surg 2021; 44(1): 262-268.
  53. Ehsaei MR, Sarreshtedar A, Ashraf H, Ghayoor Karimiani E. Trauma Mortality: Using Injury Severity Score (ISS) for Survival Prediction in East of Iran. Razavi Int J Med 2014; 2(1): 1-5.
  54. Mohammed Z, Saleh Y, AbdelSalam EM, Mohammed NBB, El-Bana E, Hirshon JM. Evaluation of the Revised Trauma Score, MGAP, and GAP scoring systems in predicting mortality of adult trauma patients in a low-resource setting. BMC Emerg Med 2022; 22(1): 90.
  55. Bouzat P, Legrand R, Gillois P, Ageron FX, Brun J, S, et al. TRENAU Group. Prediction of intra-hospital mortality after severe trauma: which pre-hospital score is the most accurate? Injury 2016; 47(1): 14-18.