[A different approach to trauma scoring]. / Travma skorlamasina farkli yaklasim.

ABSTRACT

BACKGROUND: We have compared the Injury Severity Score (ISS) at admission to Emergency Surgery and Trauma Center (ES&TC) with the ISS during autopsy. Cases with ISS less than 14 (defined as preventable deaths) were evaluated and the results were compared with those in other countries. METHODS: The study was performed between January 1, 2000 and December 31, 2002 at Istanbul Medical Faculty TS&ES and the Turkish Council of Forensic Medicine. The 160 autopsies of trauma deaths which could have been performed within this three year period were evaluated. RESULTS: The average age of trauma victims in the study was 32,9+/-15,6 (r=1-79); the majority of victims were males 78,1% (n=125). In four autopsies (3%) ISS were rated as "preventable death" (ISS < or =14). The severely injured (ISS 16-66) patients with lower survival rates were 96% (n=155). In addition, one case (1%) had an ISS score of 75. In clinical evaluations, ISS scores were found to be between 16-66 (68%), 75 (20%, n=32), and < or =14 (12%; n=19). CONCLUSION: Although it is widely used, difficulties in the applications of ISS still exist. Alcohol, drug, pregnancy and the presence of underlying diseases are the factors contributing to death but not being reflected by ISS. Moreover a difficulty exists in the evaluation of anatomical injuries which are not accompanied by physiological changes. ISS should be improved according to updates. In this way, evaluation of clinics' care quality and standardization of trauma centers can be done more accurately.