فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: Trauma is a major global health concern, with severity ranging from minor injuries to life-threatening conditions. While some patients can be managed on an outpatient basis, others require urgent intervention. Timely and accurate triage is essential to reduce mortality and morbidity in severe cases. To support rapid clinical decision-making, especially in prehospital and emergency settings, several trauma scoring systems have been developed to stratify risk and prioritize care. This study aimed to compare the predictive performance of five commonly used trauma scoring systems in estimating 28-day mortality in adult trauma patients.   Methods: This retrospective study included adult trauma patients (≥18 years) transported by 112 ambulance services to Kütahya Health Sciences University Emergency Department between December 1, 2019, and December 31, 2021. Prehospital Index (PHI), triage-Revised Trauma Score (T-RTS), Glasgow Coma Scale (GCS), Mechanism-GCS-Age-Arterial Pressure (MGAP), and Modified Rapid Emergency Medicine Score (mREMS) were calculated. The association of scores with 28-day mortality was investigated. Receiver operating characteristic (ROC) analysis was used to determine the predictive value.All statistical analyses were conducted using Statistical Package for the Social Sciences (SPSS) software.   Results: Exactly 4,142 trauma patients were included in this study. Approximately 62% of the patients were male (n=2,567), and 3.4% (n=141) of them died in the first 28 days. The mean age of the surviving patients was 41.2±22.8 years, and the mean age of the non-survivor patients was 72.3±20.6 years (P<0.001). The mechanism of trauma was blunt trauma in 92.4% of the patients in the survivor group (n=3,699) and 97.9% in the non-survivor group (n=138) (P=0.013). It was observed that the mREMS, MGAP, GCS, RTS, and T-RTS scores were predictive of mortality in the first 28 days (P<0.001), whereas the PHI score was not (P=0.1501). The score with the highest predictive value was the mREMS (Area Under the Curve (AUC): 0.902; P<0.001; 95% Confidence Interval (CI): 0.892–0.910).   Conclusion: The mREMS and MGAP scores were superior to other systems in predicting short-term mortality in trauma patients.