Benefit of Revised Trauma Score in Determining Admission to Trauma ICU Ward at Siriraj Hospital
Lertpong Somcharit MD*, Sirichai Thadapradit MD*, Dhinada Bordeesrisakul MD**
Affiliation : * Division of Trauma Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Nursing, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Objective : Trauma is one of the most common causes of death in Thailand. Most seriously injured patients need admission to
ICU, but there are no definitive criteria for ICU admission especially for trauma patients. Revised Trauma Score (RTS) is
widely used worldwide for trauma triage because it is effective and easy to calculate. The purpose of this study is to evaluate
the benefits of RTS in determining category of admission to trauma ICU ward or general trauma ward. Moreover, to analyze
APACHE II currently being used in general ICU, then compare the scores to RTS.
Material and Method: A retrospective review of trauma registry data from January to June 2015 of 109 trauma patients
who were brought to resuscitation room of Division of Trauma, Siriraj Hospital. 69 patients were admitted to trauma ICU,
40 patients were admitted to general trauma ward. RTS of both groups were calculated. Demographic data, ISS, hospital stay
and mortality rate were collected. APACHE II was also calculated in trauma ICU group.
Results : A total of 109 patients, sixty-nine patients were admitted at Trauma ICU, the median RTS was 7.11, forty patients were
admitted at general trauma ward; the median RTS was 7.84. After adjusted data, median RTS of TICU and the ward groups
were 6.9 and 7.84. The appropriate cutoff point of RTS in determining category of admission to TICU was RTS <7. The
average APACHE II in ICU group was 8. The correlation between RTS and APACHE II was -0.356.
Conclusion : The RTS can be used as the guideline in determining which trauma patients require TICU admission or general
trauma ward admission. The appropriate cutoff point is RTS <7. RTS and APACHE II are different and cannot replace each
other. They both have benefits, RTS is good as an initial screening tool, whereas APACHE II is better in ward monitoring.
Keywords : Trauma ICU admission, RTS
