Comparison of Emergency Trauma Score (EMTRAS) with Rapid Emergency Medicine Score (REMS) for Prediction of Early Mortality in Adult Trauma Patients

Gautam Kumar; Ranvinder Kaur; Rupesh Yadav; Nisha Kachru

doi:10.18502/aacc.v8i3.9608

Gautam Kumar Department of Anesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India
Ranvinder Kaur Department of Critical Care Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India
Rupesh Yadav Department of Anesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India
Nisha Kachru Department of Anesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India

DOI: https://doi.org/10.18502/aacc.v8i3.9608

Keywords: Trauma; Survivors; Mortality; Hospitals

Abstract

Background: Trauma is an injury to living tissue from an external source. The severity of traumatic injuries plays a crucial role in the determination of mortality in patients with trauma, thus a proper understanding of the severity of trauma is very important for improving trauma care. Several scoring systems are available for the objective, initial assessment of the severity of injury to help treatment strategy. Aim of the study was to compare Emergency Trauma Score (EMTRAS) with Rapid Emergency Medicine Score (REMS) for prediction of early mortality in adult trauma patients.

Methods: Study was conducted with 100 patients of either sex, age 18 years or above with history of trauma due to road accident, fall and assault. REMS and EMTRAS score was calculated from the laboratory and patient characteristics mentioned in the Trauma scoring datasheet, within 30 minutes of arrival of the patient in the hospital and 24 hours after hospitalization.

Results: Comparison of the REMS score within 30 mins of patient arrival and at 24 hrs was statistically significant (p=0.0099). Comparison of EMTRAS SCORE Within 30 mins of patient arrival and at 24 hrs was not statistically significant (p=0.0505). Comparison of REMS vs Outcome at 24 hrs (Non-Survivors and Survivors) was statistically significant (p=<0.0001). Comparison of EMTRAS vs Outcome at 24 hrs (Non-Survivors and Survivors) was statistically significant (p=<0.0001). Comparison of AUROC (Area Under the Receiver Operating Characteristics) of REMS and EMTRAS were 0.689 and 0.789 respectively, which was statistically significant.

Conclusion: We conclude that both REMS and EMTRAS are easy, accurate predictors of in-hospital early mortality in Adult Trauma Patients. But in our study, EMTRAS AUROC was greater than AUROC of REMS. Hence EMTRAS should have good prognostic power for predicting in-hospital early mortality in Adults Trauma patients.