Evaluation of the revised trauma and injury severity scores in elderly ...

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Mar 2, 2012 - Aims: We sought to determine the accuracy of the injury severity score (ISS) and the revised trauma score (RTS) in predicting mortality and ...
Original Article

Evaluation of the revised trauma and injury severity scores in elderly trauma patients Hannah F Watts, Yaniv Kerem, Erik B Kulstad Department of Emergency Medicine, Advocate Christ Medical Center, 4440 W. 95th St., Oak Lawn, USA

ABSTRACT Background: Severity-of-illness scoring systems have primarily been developed for, and validated in, younger trauma patients. Aims: We sought to determine the accuracy of the injury severity score (ISS) and the revised trauma score (RTS) in predicting mortality and hospital length of stay (LOS) in trauma patients over the age of 65 treated in our emergency department (ED). Materials and Methods: Using the Illinois Trauma Registry, we identified all patients 65 years and older treated in our level I trauma facility from January 2004 to November 2007. The primary outcome was death; the secondary outcome was overall hospital length of stay (LOS). We measured associations between scores and outcomes with binary logistic and linear regression. Results: A total of 347 patients, 65 years of age and older were treated in our hospital during the study period. Median age was 76 years (IQR 69-82), with median ISS 13 (IQR 8-17), and median RTS 7.8 (IQR 7.1-7.8). Overall mortality was 24%. A higher value for ISS showed a positive correlation with likelihood of death, which although statistically significant, was numerically small (OR=1.10, 95% CI 1.06 to 1.13, P