IMPORTANCE OF ISS AND RTS IN TRAUMA PATIENTS OF A TERTIARY REFERRAL CENTRE IN EASTERN INDIA

Abstract

BACKGROUND Trauma represents the third cause of death after cardiovascular disease and malignancy. Also in India, road traffic accidents are one of the leading causes of death. Rapid evaluation of trauma severity, prediction of prognosis and mortality rate and probability of survival along with rapid treatment of patients is necessary. One of the useful instrument for this is ISS and RTS scoring systems. This study evaluated 100 multitrauma patients in a tertiary referral hospital in eastern India based on ISS and RTS and compared their effectiveness on outcome. MATERIALS AND METHODS This prospective observational study was carried out on 100 polytrauma patients admitted in Nilratan Sircar Medical College and Hospital over a span of 7 months from January 2013 to July 2013. During this period, patients' data were collected by clinical evaluation and they were followed till discharge or death. The statistical outcome was done using SPSS software. RESULTS The average age of patients was 37.6 +/- 23.5 years where minimum and maximum age was 12 and 85 years. The most common involved group was 31-40 years (13 men and 1 woman). 84% of patients (84 cases were male) and 16% were female (16 cases). The most common causes of trauma were road traffic accidents with 76% frequency (76 cases) and then fall from height with 12.0% frequency (12 cases). Road traffic accident had the highest frequency in both genders. Other causes of trauma were physical assaults with 6% frequency (6 cases) and gunshot injury 6% (6 cases). Also from 100 studied patients, 5 cases (5%) had blunt trauma and 2 cases (2%) had penetrating trauma. The penetrating trauma occurs in ages less than 50 years and was in the range of 30-50 years. The average RTS was 6.4 +/- 0.47 for patients who recovered well and 5.7 +/- 0.57 for patients who didn't survive. For ISS it was 33.7 +/- 1.9, patients who were discharged; and 34.7 +/- 1.6, those who couldn't survive. Overall mortality was 13% (13 cases). In this study, the trauma score based on RTS correlated better than ISS with the overall clinical outcome. CONCLUSION The RTS scoring system performed better than the ISS in predicting mortality and probability of survival and hence a better and accurate trauma score system.