Evaluation of the predictive value of thorax trauma severity score (TTSS) in thoracic-traumatized patients

Abstract

Abstract Background Thorax trauma severity score (TTSS) combines patient-related parameters with the anatomical and physiological parameters, and it can be easily calculated in the emergency room. The validity of this score in the Egyptian population has not been tested; therefore, the objective of this study was to evaluate the prognostic role of TTSS to predict the outcome of thoracic trauma in the Egyptian patients in two centers. Results The study included 284 male patients (94.7%) with a mean age of 41 years. Fifty-six patients (18.7%) had conservative management, 216 had morbidity (72%), and 28 patients died (9.3%). One hundred forty-eight patients (49.3%) had a thoracostomy tube, and thoracotomy was required in 4 patients (1.3%). Respiratory rate above 20 cycles/min at admission was associated with mortality (n = 28 (9.3%); p < 0.001). One hundred thirty-six patients had TTSS between 0 and 5 points; 56 of them were discharged and 80 of them were admitted to the inpatient ward with a good prognosis. Twenty-four patients had TTSS between 21 and 25 points; all the 24 patients had a fatal prognosis. A cut-off value of 7 points or more of TTSS was 100% sensitive and 97.73% specific to poor and fatal prognosis, and it was significantly associated with acute respiratory distress syndrome and the need for mechanical ventilation (n = 64; p < 0.001; AUC = 0.998). Conclusion The outcome of thoracic trauma patients could be predicted based on the thorax trauma severity score. A score of 7 points or above was associated with increased morbidity, and a score of 20 points or above predicted a fatal prognosis and prolonged mechanical ventilation.

Keywords

• Thorax trauma severity score
• Thoracic trauma
• Outcome prediction