AIS %26gt; 2 in at least two body regions: A potential new anatomical definition of polytrauma

作者：Butcher Nerida; Balogh Zsolt J^*

来源：Injury-International Journal of the Care of the Injured, 2012, 43(2): 196-199.

DOI：10.1016/j.injury.2011.06.029

• Polytrauma
• Injury Severity Score
• Abbreviated Injury Scale
• Multiple organ failure
• Trauma outcomes

Background: The term %26apos;polytrauma%26apos; lacks a universally accepted, validated definition. In clinical trials the commonly applied injury severity based anatomical score cut-offs are ISS %26gt; 15, ISS %26gt; 17 and a recently recommended AIS %26gt; 2 in at least two body regions (2 x AIS %26gt; 2). %26lt;br%26gt;Purpose: To compare the outcomes of clinically defined polytrauma patients with those defined based on anatomical scores. %26lt;br%26gt;Material and methods: A prospective observational study on all trauma team activation patients over a 7-month period presenting at a level-1 trauma centre were included in the study. The prospective data collection included AIS in each body region, ISS, ICU length of stay (LOS), multiple organ failure (MOF) and mortality. %26lt;br%26gt;Results: 336 patients met inclusion criteria (age: 41 +/- 20, 74% male, ISS: 15 +/- 11, NISS: 19 +/- 15, MOF: 3%, mortality: 4%, 25% ICU admission). ISS %26gt; 15: 13 deaths (10%), 71 (54%) required ICU admission and 10 (8%) developed MOF. ISS %26gt; 17 captured 11 deaths (11%), with 63 (62%) requiring ICU admission and 10 (10%) developing MOF. Defining as (2 x AIS %26gt; 2): 8 deaths (13% of the group), with 43 patients requiring ICU admission (67%) and 9 (14%) developing MOF. When examining the performance of these three approaches, the ISS %26gt; 15 and the ISS %26gt; 17 captured statistically the same amount of clinically defined polytrauma patients (p = 0.4106), while the 2 x AIS %26gt; 2 definition captured significantly more polytrauma patients than ISS %26gt; 15 (p = 0.0251) and ISS %26gt; 17 (p = 0.0019). %26lt;br%26gt;Conclusion: 2 x AIS %26gt; 2 captured the greatest percentage of the worst outcomes and significantly larger % of the clinically defined polytrauma patients. 2 x AIS %26gt; 2 has higher accuracy and precision in defining polytrauma than ISS %26gt; 15 and ISS %26gt; 17. This simple, retrospectively also reproducible criteria warrants larger scale validation.

• 出版日期2012-2