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Adult trauma prehospital evaluation: Old or new scores?

2019; Volume: 44; Issue: 1 Linguagem: Inglês

10.5937/tmg1901031g

2406-1042

Zoran Gojković, Radojka Jokšić-Mazinjanin, Velibor Vasović, Gordana Smieško, Predrag Šaponja, Radmila Petrović, Milena Jokšić-Zelić, Siniša Saravolac, Momir Mikov,

Abdominal Trauma and Injuries

Context: Severe trauma is a leading cause of mortality and high-degree invalidity. Emergency Medical Services (EMS) are usually first-line responders to the traumatized persons and the management of traumatism and its dynamics depend on the accurate evaluation by the EMS providers. In order to evaluate the severity of injury, it is necessary to use the adequate trauma score (TS). The aim of this paper is to compare the most common prehospital scoring system RTS (Revised TS) with newly developed MGAP (Mechanism, Glasgow Coma Scale, Age and Arterial Pressure) and GAP (Glasgow Coma Scale, Age and Arterial Pressure), based on the published studies, in order to determine better triage and predictive value, i.e. the highest sensitivity and specificity. Methods: Our search through the large indexical data bases (Web of Science, Scopus, PubMed, Serbian Citation Index), completed on 01 May 2017, discovered numerous articles about trauma scores. Results: Prehospitally, most commonly used score is a RTS. After viewing large indexed data bases, we found studies comparing RTS with newly developed scores, such as MGAP and GAP. MGAP and GAP have better triage and predictive value than RTS. In addition to this, these scores are easier to use and calculate. In most cases, it is possible to calculate them retrospectively, which is not the case with RTS. Its importance is even more prominent in low and middle-income countries, where there are great differences in availability, quality and equipment between medical centres. Conclusions: After analyzing five studies, we concluded that new scores are easier to apply, with equal or improved triage and predictive values regarding the outcome of the trauma.