The Prototype Scoring System in Predicting Probability of Survival for Multiple Trauma Patients in Indonesia
نویسندگان
1 Department of Emergency Medicine, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar General Hospital, Malang – Indonesia
2 Department of Emergency Medicine, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar General Hospital, Malang – Indonesia
3 Department of Emergency Medicine, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar General Hospital, Malang – Indonesia
4 Department of Emergency Medicine, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar General Hospital, Malang – Indonesia
5 Department of Public Health, Faculty of Medicine, Universitas Brawijaya, Malang - Indonesia
doi
Doi:10.34172/jept.2025.18چکیده
Objective: Trauma-related deaths are among the top 10 causes of mortality, with an average ofthree deaths from traffic accidents every hour in Indonesia. In 2012, there were 117,949 trafficaccidents resulting in 29,544 deaths (25.04%). In 2021, there were 103,645 accidents with 25,266deaths (24.37%). Despite efforts to record trauma cases in Indonesia, existing scoring systems fromdeveloped countries face limitations. This study aims to propose a new, locally adapted scoringsystem to improve the management of multiple trauma cases, particularly at Saiful Anwar GeneralHospital (RSSA), Malang.Methods: This observational analytic study with a retrospective cohort design was conducted atRSSA, Malang, Indonesia, from January 2021 to December 2022. A total of 506 multiple traumapatients from the RSSA Emergency Department were included, selected through purposivesampling. Data analysis involved the use of the t-test or the Mann-Whitney U test for numericaland ordinal data, the chi-square or Fisher’s test for nominal data, followed by multivariate logisticregression to establish a scoring system.Results: Logistic regression through backward elimination identified 15 significant predictors ofin-hospital mortality: age (P=0.000, OR=0.967), pulse rate (P=0.006, OR=0.981), GCS (P=0.000,OR=1.381), intracerebral hemorrhage (P=0.105, OR=0.966), subdural hemorrhage (P=0.001,OR=0.875), infratentorial hemorrhage (P=0.000, OR=0.151), subfalcine herniation (P=0.038,OR=0.871), transtentorial herniation (P=0.050, OR=0.038), mandibular fracture (P=0.004,OR=0.235), etc. GCS was the strongest predictor (Wald=50.54). Although intracerebral hemorrhageand lung tissue injury (P>0.05) were retained due to clinical relevance, the model showed excellentdiscriminatory power, with an area under the curve (AUC-ROC) of 0.917 and a 95% confidenceinterval of 0.886–0.948.Conclusion: The MTPS scoring system developed in this study can predict the prognosis of multipletrauma patients with strong discrimination (0.917) and is expected to improve the quality of traumacare in accordance with WHO guidelines at RSSA Malang.
