Designing a tool for assessing injury severity parameters in order to develop a national Iranian model for auditing preventable trauma-related death
Keywords:Trauma score, Iran, Death, Predictors, National model
Background: The medical definition of trauma is “any kind of intentional or unintentional, penetrating or non-penetrating injury or wound caused by external causes”. Traumatic injury is a health threat all over the world and the cause of 9% of worldwide mortality. Having a total of 258 trauma-scoring models indicates the versatile state of using trauma scores. Currently, there are no national models for prediction of trauma-caused preventable death in Iran; This study, conducted in 2018 and 2019, aimed to adapt a national model for Iran.
Methods: Using appropriate keywords, the most commonly used scales for predicting death in traumatic patients were searched from literature. These included ISS, GCS, TRISS, GAP, MGAP, PTS, REMS, APACHE II, T-RTS, RTSc, NISS, MISS, and PHI. The potential trauma mortality determinants and parameters were then identified and organized in a data collection form to be measured through prospective examination of trauma cases after being assessed for its content validity.
Results: The final tool was comprised of three sections. The first section should be completed through the first day of admission to an emergency department. It included the following items: pre-hospital health services, past medical history, medication use, Glasgow Coma Scale, vital signs, routine laboratory tests in trauma, psychoactive and addictive drug history and alcohol misuse, AIS index, PTS, trauma mechanism and external cause according to International Classification of Diseases. The second section belonged to secondary evaluation 24 hours after the first evaluation and included vital signs, GCS, AIS and admission decision. The third section was for one-month follow-up and included the Glasgow Outcome Scale.
Conclusion: The developed tool at three sections was found valid and applicable based on expert views and identified feasible through its pilot administration.
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