Injury
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Comparative Study
Trauma triage: a comparison of CRAMS and TRTS in a UK population.
The CRAMS scale and the Triage Revised Trauma Score (TRTS) were compared to assess their potential use as a prehospital method of activating hospital trauma teams. We studied patients from the resuscitation room of Leeds General Infirmary who had enough data recorded to allow calculation of the admission TRTS and CRAMS scale. Patients were defined as having major injury if they died in hospital, were admitted to the ICU or had an Injury Severity Score (ISS) of > 15. ⋯ The TRTS was significantly more specific (0.9 versus 0.75) but at a cost of poor sensitivity (0.6 versus 0.69, not significant). The performance of both scales was similar when compared on the ROC curve. CRAMS and the TRTS were unable to identify major injuries in our sample with sensitivity and specificity adequate to support their use as a tool to activate trauma teams in the UK.
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A consecutive series of 103 patients with a subtrochanteric fracture were prospectively studied. Ten patients were treated non-operatively, whilst the other 93 had operative treatment. ⋯ No method of fracture classification was demonstrated to be of value in predicting either the choice of treatment or the risk of fracture healing complications. Either intramedullary nailing or extramedullary fixation with a dynamic hip screw appear to give the best results for subtrochanteric fractures.