The predictive value of triage early Warning Score (TEWS) on mortality of trauma patients presenting to the Emergency Department

Abstract

INTRODUCTION: Posttraumatic injuries are among the most frequent reasons of admission to emergency room services (ERs). In the first assessment of the cases, ATLS protocols recommends use of triage decision scheme consisting of parametres of abnormal physiologic findings, anatomic injury site, pathogenic mechanism of injury, concomitant diseases and conditions, and activation of trauma teams in line with these criteria. The aim of this study is to evaluate TEWS(Triage Early Warning Score) as a marker for predicting mortality in trauma patients who presented to Emergency Services.

MATERIALS AND METHODS: 381 trauma patients aged ≥ 18 years who admitted to the Emergency Service and met criteria of ATLS protocol were included in the study.TEWS values of the patients were calculated using patients’data included in the study forms. Impact level was scrutinized using multivariant logistic regression test. Level of statistical significance was accepted as p<0.05.

RESULTS: In the prediction of survival and ex patient rates; significant effectiveness of TEWS was observed [0.973 (0.9441)] (p<0.05). In the ROC analysis maximum TEWS AUC value was [0.930 (0.895-0.966)] with a cut-off value of 5 points. TEWS scores of 17.2% (66/381) of the patients who were discharged were above 5 points. These patients had undergone intubation (n= 21; 35%), tube thoracostomy (n= 16; 26.6%), transfusion of blood products (n= 29; 48.3%), and emergency surgery (n=16; 26.6%).

CONCLUSIONS: Triage Early Warning Score is effective in the prediction of emergency treatment, and prognosis in trauma patients hospitalized in the emergency services, and it may identify patients under risk. We think that Triage Early Warning Score together with ATLS protocol can be used as an easily applicable triage warning trauma score in trauma patients.