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Войти в исследования European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026
Evaluation and Proposed Refinement of the Thoracic Trauma Severity Score: Improving Prognostic Accuracy in Blunt Chest Trauma Including Polytrauma Patients.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Fouda Noha Mohamed Ashraf, Gwely Nour El-Din Noaman, Awad Gehad Ibrahim, Sanad Mohammed Abdelfattah
Аннотация
OBJECTIVES: To evaluate and test the prognostic performance of a modified TTSS that adds body mass index (BMI) and Glasgow Coma Scale (GCS), with emphasis on polytrauma.
METHODS: Prospective observational study of 302 adults with blunt chest trauma (December 2022-May 2023). Patients were stratified into isolated thoracic trauma and polytrauma. We assessed in-hospital mortality and prolonged hospital stay (>7 days) using ROC analysis and multivariate logistic regression.
RESULTS: Mean age 44.6 ± 17.1 years; 88.7% male; 50.3% polytrauma; mortality 12.9%. For mortality, modified TTSS discriminated better than TTSS (AUC 0.857 vs. 0.729); cut-offs were >8 and >6, respectively. For prolonged stay, performance was modest overall, with slight improvement using Modified TTSS (AUC 0.657 vs. 0.644; cut-offs >7 vs. >6). In polytrauma, modified TTSS again outperformed TTSS for mortality (AUC 0.821 vs. 0.680). On multivariable analysis, TTSS >6 and Modified TTSS >8 independently predicted mortality; both scores also predicted prolonged stay.
CONCLUSIONS: The Modified TTSS, incorporating BMI and GCS, improves early risk stratification-particularly in polytrauma-and may support triage and resource allocation.
METHODS: Prospective observational study of 302 adults with blunt chest trauma (December 2022-May 2023). Patients were stratified into isolated thoracic trauma and polytrauma. We assessed in-hospital mortality and prolonged hospital stay (>7 days) using ROC analysis and multivariate logistic regression.
RESULTS: Mean age 44.6 ± 17.1 years; 88.7% male; 50.3% polytrauma; mortality 12.9%. For mortality, modified TTSS discriminated better than TTSS (AUC 0.857 vs. 0.729); cut-offs were >8 and >6, respectively. For prolonged stay, performance was modest overall, with slight improvement using Modified TTSS (AUC 0.657 vs. 0.644; cut-offs >7 vs. >6). In polytrauma, modified TTSS again outperformed TTSS for mortality (AUC 0.821 vs. 0.680). On multivariable analysis, TTSS >6 and Modified TTSS >8 independently predicted mortality; both scores also predicted prolonged stay.
CONCLUSIONS: The Modified TTSS, incorporating BMI and GCS, improves early risk stratification-particularly in polytrauma-and may support triage and resource allocation.