Background: The ideal diagnostic model for estimating trauma severity should be clinically sensitive, well-calibrated, and able to include a wide range of patients. This study investigates the predictive value of the Injury Severity Score (ISS), Revised GAP (GCS, Age, and Pressure) score, GAP and new trauma score (NTS) in predicting mortality in multi-trauma patients. Methods: This cross-sectional descriptive study included 170 multi-trauma patients referred to Imam Reza Trauma Center in Tabriz during September 2022-2023. Data related to demographic variables, clinical status, and ISS index were collected. In-hospital and overall mortality (30-day mortality) were recorded as outcomes. Results: Average age of patients was 39.29±21.14 years, and 71.2% were male. The mean ISS score in deceased and surviving patients was 38.61±17.12 and 9.73±1.46, respectively (P˂0.001). 24-hour mortality (early mortality) was 8.2% and the frequency of overall mortality was 21.1%. Regarding overall mortality, the ISS cut-off point was 19, with a sensitivity of 86% and a specificity of 83%. The R-GAP cut-off point was 16.5, with a sensitivity of 84% and a specificity of 86% for predicting the early survival of patients. GAP showed an AUC of 0.874, 82% sensitivity and 85% specificity, and NTS showed an AUC of 0.866, 87% sensitivity and 77% specificity. For overall mortality, R-GAP showed an AUC of 0.948, with 94% sensitivity and 81% specificity compared to GAP with an AUC of 0.938, 92% sensitivity and 83% specificity, and NTS with an AUC of 0.922, 90% sensitivity and 81% specificity. Conclusion: According to the results obtained in this study, it can be concluded that in patients referred to the emergency department with traumatic injuries, the ISS and R-GAP tools could be reliable measures to estimate the risk of early mortality/survival rate within 24 hours after injury.
Boukani et al. (Tue,) studied this question.