ASSESSMENT OF FACTORS PREDICTING MORTALITY IN TRAUMA PATIENTS USING REVISED TRAUMA SCORE: A PROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA
Main Article Content
Keywords
Revised Trauma Score, Trauma mortality, Glasgow Coma Scale, Injury severity, Emergency triage
Abstract
Trauma constitutes a major public health burden globally, with developing countries bearing a disproportionate share of mortality and morbidity. Early identification of high-risk patients through validated scoring systems is essential for optimal triage and resource allocation. The Revised Trauma Score (RTS), incorporating Glasgow Coma Scale, systolic blood pressure, and respiratory rate, serves as a widely utilized physiological scoring tool for mortality prediction. This study aimed to assess factors predicting mortality in trauma patients using RTS and evaluate its predictive accuracy in an Indian tertiary care setting.
Methods: A prospective observational study was conducted at Gouri Devi Institute of Medical Sciences and Hospital, West Bengal, from July 2024 to December 2024. A total of 168 trauma patients meeting inclusion criteria were enrolled through consecutive sampling. Demographic data, injury characteristics, and RTS parameters were recorded. Mortality prediction accuracy was assessed using receiver operating characteristic curve analysis, and logistic regression identified independent predictors.
Results: The study population comprised predominantly males (82.1%) with mean age of 37.42 years. Road traffic accidents were the leading mechanism (66.7%). Overall mortality was 16.7%. Non-survivors had significantly lower mean RTS (3.68 vs. 6.82, p<0.001) compared to survivors. The RTS demonstrated excellent discriminatory ability with area under curve of 0.924. At optimal cutoff of 5.68, sensitivity was 89.3% and specificity was 87.1%. Glasgow Coma Scale below 9 emerged as the strongest mortality predictor (OR: 8.64).
Conclusion: The Revised Trauma Score effectively predicts mortality in trauma patients, demonstrating excellent discriminatory ability. Implementation of RTS-based triage protocols is recommended for emergency departments in resource-limited settings to facilitate early identification of high-risk patients.
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Dr. Anup Kumar Dokania
Associate Professor, Department of Orthopedics, Gouri Devi Institute of Medical Sciences and Hospital, Durgapur, West Bengal
Dr. Ajay Kumar Kundan
Associate Professor, Department of Orthopedics, Shyamlal Chandrashekhar Medical College & S.P.N.M. Speciality Hospital, Khagaria, Bihar
Dr. Amar Satyam
Assistant Professor, Department of Orthopedics, Shyamlal Chandrashekhar Medical College & S.P.N.M. Speciality Hospital, Khagaria, Bihar
