Settlement Is at the End-Common Trauma Scores Require a Critical Reassessment Due to the Possible Dynamics of Traumatic Brain Injuries in Patients' Clinical Course

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Jun 19

PMID 38893044

Authors

Jason-Alexander Horauf

Mathias Woschek

Cora Rebecca Schindler

Rene Danilo Verboket

Thomas Lustenberger

Ingo Marzi

Philipp Stormann

Affiliations

Soon will be listed here.

Abstract

Scientific studies on severely injured patients commonly utilize the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) for injury assessment and to characterize trauma cohorts. However, due to potential deterioration (e.g., in the case of an increasing hemorrhage) during the clinical course, the assessment of injury severity in traumatic brain injury (TBI) can be challenging. Therefore, the aim of this study was to investigate whether and to what extent the worsening of TBI affects the AIS and ISS. We retrospectively evaluated 80 polytrauma patients admitted to the trauma room of our level I trauma center with computed-tomography-confirmed TBI. The initial AIS, ISS, and Trauma and Injury Severity Score (TRISS) values were reevaluated after follow-up imaging. A total of 37.5% of the patients showed a significant increase in AIS (3.7 vs. 4.1; = 0.002) and the ISS (22.9 vs. 26.7, = 0.0497). These changes resulted in an eight percent reduction in their TRISS-predicted survival probability (74.82% vs. 66.25%, = 0.1835). The dynamic nature of intracranial hemorrhage complicates accurate injury severity assessment using the AIS and ISS, necessitating consideration in clinical studies and registries to prevent systematic bias in patient selection and subsequent data analysis.

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