• Sadiye Yolcu, Kemal Sener, Hatice Tapsiz, Ali Ilker Ozer, and Akkan Avci.
• Department of Emergency Medicine, Adana City Research & Education Hospital, Adana, Turkey.
• Ir J Med Sci. 2023 Aug 1; 192 (4): 185518601855-1860.

BackgroundTrauma is one of the common reasons for emergency department (ED) presentations. Specifically, severe-trauma patients often present with mortal complications, including traumatic shock or respiratory or multiorgan failure/dysfunction, and these situations cause high-mortality risk. Scoring systems in the triage of trauma patients can help determine the injury's severity and the patient's prognosis.AimIn this study, we aimed to compare Early-Warning Score (EWS), Revised Trauma Score (RTS), and CRAMS to predict the severity and prognosis of damage among high-energy-trauma patients.MethodsThis retrospective study included adult high-energy-trauma patients (> 18 years of age) assessed in our emergency department (ED) from April 1, 2020, to September 31, 2020. We included a total of 177 high-energy-trauma patients in the study. We compared the effectiveness of EWS; RTS; and circulation, respiration, abdomen, motor, and speech (CRAMS) in predicting mortality. The primary outcome of this study was mortality.ResultsWe included 67 females and 110 males with a mean age of 39.2 in our study. Of those patients, 6 died during ICU hospitalization and 104 were discharged from the ward. RTS (AUC: 0.978, CI: 0.945-0.994, p < 0.001) and CRAMS (AUC: 0.978, CI: 0.944-0.994, p < 0.001) had the same AUC values, but the AUC value of EWS (AUC: 0.966, CI: 0.927-0.987, p < 0.001) was lower. Sensitivity of EWS was 93.1 (CI: 77.2-99.2%), and sensitivity of RTS was 96.55 (CI: 82.2-99.9) and CRAMS' sensivity was 96.55% (CI: 82.2-99.9). RTS showed the highest specivity level (96.62%, CI: 92.3-98.9).ConclusionIn conclusion, RTS and CRAMS better predicted mortality in high-energy-trauma patients than EWS.© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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