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Original Article
- Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea
- Hongrye Kim, Mou Seop Lee, Su Young Yoon, Jonghee Han, Jin Young Lee, Junepill Seok
- J Trauma Inj. 2024;37(2):114-123. Published online May 9, 2024
- DOI: https://doi.org/10.20408/jti.2023.0087
- 8,503 View
- 235 Download
- 4 Web of Science
- 5 Citations
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Abstract
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Supplementary Material - Purpose
Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients.
Methods
Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma.
Results
In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5–15] vs. 15 [14–15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively)
Conclusions
Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended. -
Summary
Citations
Citations to this article as recorded by
- Evaluation and Proposed Refinement of the Thoracic Trauma Severity Score: Improving Prognostic Accuracy in Blunt Chest Trauma Including Polytrauma Patients
Noha Mohamed Ashraf Fouda, Nour El-Din Noaman Gwely, Gehad Ibrahim Awad, Mohammed Abdelfattah Sanad
European Journal of Cardio-Thoracic Surgery.2026;[Epub] CrossRef - Accurate, fair, and generalisable scaling of injury severity score-based AI with demographics in terms of mortality in patients with trauma: multi-centre, multi-national retrospective cohort study
Yunjeong Choi, Junepill Seok, Thomas Young-Chul Oh, Jeremy Hsu, Do Wan Kim, Byungchul Yu, Jayun Cho, Woocheol Jang, Jina Kim, Na-eun Oh, Jehyeuk Ahn, Robert J. Femia, Paul A. Testa, Dong Keon Yon, Daniel K. Sodickson, Wu Seong Kang, Jinseok Lee
eBioMedicine.2026; 126: 106206. CrossRef - Development and validation of a prediction model for respiratory complications and in-hospital mortality in trauma patients
Do Wan Kim, Dongjin Yeo, Juyeong Kim, Yerin Hwang, Hyunjee Kim, Seung Ha Hwang, Jaeyu Park, Jinseok Lee, Jaehyeong Cho, Selin Woo, Junepill Seok, Byungchul Yu, Youngmin Kim, Sebeom Jeon, Dong Keon Yon, Wu Seong Kang
Scientific Reports.2026;[Epub] CrossRef - Clinical and instrumental diagnosis of combined fractures of the clavicle and ribs
O.A. Burianov, V.Р. Kvasha, M.V. Кrаvchuk, D.V. Miasnikov
EMERGENCY MEDICINE.2025; 21(8): 800. CrossRef - Clinical prediction models for the management of blunt chest trauma in the emergency department: a systematic review
Ceri Battle, Elaine Cole, Kym Carter, Edward Baker
BMC Emergency Medicine.2024;[Epub] CrossRef
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