A simplified emergency trauma score for predicting mortality in emergency setting

Aims: The aim of the study was to develop a simplified emergency trauma score (SETS) for rating injury severity as well as triaging and predicting mortality in Hong Kong. Background: Many existing trauma scoring systems require measurements that are not generally available in emergency settings in Hong Kong. As many of these important measures in the scoring systems are not available before the patients are admitted in the hospitals, it may delay treatment because of the extent of a patient's injury is often not clear at the site of accident or in the emergency settings. Design: A retrospective cohort analysis of trauma patients' records from Trauma Registry in Hong Kong was performed. Method: Potential significant parameters in predicting mortality were identified by univariate analysis. Binary logistic regression then was used to develop an equation for SETS. Four parameters including age, Glasgow coma scale, respiratory rate and American College of Surgeons (ACS) mechanism of injury were identified, and the reliability and validity of SETS was assessed. Results: At cut-off point of a SETS score of 60, the sensitivity and specificity of SETS were 64% and 98% respectively. The area under receiver operating characteristic curve was 0·939 which was comparable with other commonly used trauma scores. Conclusions: SETS should be considered a relevant trauma scoring system in Hong Kong emergency settings. It is suggested that similar scoring systems should be developed in other countries based upon obtainable measures in their corresponding emergency settings. Relevance to clinical practice: As a trauma scoring system is closely related to the context of its application, a system that can facilitate accurate sorting of patients into treatment hierarchies should be adopted in the congested emergency settings. Copyright © 2014 British Association of Critical Care Nurses.