Evaluating the effectiveness of trauma scores in predicting morbidity and mortality in patients with concomitant thoracic trauma.

BACKGROUND

Trauma is a major global health concern due to its potential to affect multiple organ systems and its association with high rates of morbidity and mortality. This study aimed to comparatively evaluate the accuracy of various trauma scoring systems in predicting morbidity and mortality among patients with blunt thoracic trauma across different age groups.

METHODS

A retrospective analysis was conducted on 210 patients treated for thoracic trauma at the Department of Thoracic Surgery, Kayseri City Hospital, between October 2022 and January 2024. Patients were categorized into three age groups: 18-44 years, 45-64 years, and ≥65 years. Data collected included demographic characteristics, comorbidities, anticoagulant use, mechanism of injury, thoracic and extrathoracic injuries, and histories of intensive care unit (ICU) admission and intubation. The predictive performance of the Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), Chest Trauma Score (CTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) for mortality, intubation, and ICU admission was assessed using receiver operating characteristic (ROC) analysis.

RESULTS

The mean age of the patients was 53.43 years, with a predominance of males. Traffic accidents were the most common cause of trauma. The prevalence of comorbidities and anticoagulant use increased with age. The ICU admission rate was 32.38%, and the overall mortality rate was 4.28%. ROC analysis demonstrated that ISS and TRISS had strong predictive performance for mortality, need for intubation, and ICU admission across all age groups.

CONCLUSION

Thoracic trauma is a severe form of injury associated with high rates of morbidity and mortality. The findings suggest that ISS and TRISS are reliable predictors of trauma severity regardless of age. Incorporating these scoring systems into hospital triage and clinical decision-making may facilitate early diagnosis and support timely, effective management.