Comparison Analysis Of RETRASCORE,APACHE Ⅱ And ISS In The Prognosis Of Patients With Severe Trauma

Objective:To compare the prognostic value of RETRASCORE,APACHE Ⅱ,and ISS in patients with severe trauma,to explore the accuracy and feasibility of RETRASCORE in predicting the prognosis of patients with severe trauma,and to provide a new method for prognostic evaluation and clinical research of patients with severe trauma.Methods:The clinical data of 546 patients with severe trauma admitted to the trauma ICU ward of the First Affiliated Hospital of Nanchang University from July 2020 to November 2022 were analyzed retrospectively.The patients were divided into a survival group(n=443)and a death group(n=103)according to whether they survived on the 28th day.The general data of severe trauma patients were collected,and the highest ISS,APACHE Ⅱ,and RETRASCORE within 24 hours of trauma ICU were recorded.The differences in general data,ISS,APACHE Ⅱ,and RETRASCORE between the two groups were compared,and the predictive value of the three scores on the prognosis of severe trauma patients was evaluated by the Receiver Operating Characteristic Curve.Results:In this study,546 patients with severe trauma were included,including 406 males(74.36%)and 140 females(25.64%).443 cases(81.13%)survived and 103 cases(18.86%)died.There were 273 cases(50%)of traffic accident injuries,122 cases(22%)of falling injuries,57 cases(10%)of falling injuries,30 cases(6%)of heavy objects,and 64 cases(12%)of others.There was no significant difference between the survival group and the death group in 50-65 years old,66-75 years old,sex,respiratory rate,and injury factors(P >0.05);In Age [55(44,64)vs.59(52,70)years],under 50 years [165(37.25%)vs.22(21.36%)],over 75 years [20(5.51%)vs.14(13.59%)],body temperature [37.4(36.6,38.0)℃ vs.36.8(36.3,38.1)℃],systolic blood pressure [118(99.135)mmHg vs.86(73,120)mmHg],ISS score(25.31 ± 8.62 vs.33.62 ± 11.03),APACHE II score [14(11,19)vs.29(22,34)] and RETRASCORE score [4.47 ± 3.01 vs.1267 ± 4.07],the difference was statistically significant(P<0.05).RETASCORE score(AUROC 0.935)was better than the APACHE Ⅱ score(AUROC 0.899)and ISS score(AUROC 0.734)in evaluating the prognosis of patients with severe trauma.There was a significant difference between the three scores(P < 0.05).When RETRASCORE was the best cut-off value(8 points),the sensitivity and specificity of predicting death outcomes were 82.52% and 92.10%,respectively.Conclusion:ISS,APACHE Ⅱ,and RETRASCORE can predict the death risk of severe trauma patients to a certain extent,among which RETRASCORE has the best prediction accuracy,APACHE Ⅱ score is slightly worse and ISS score is the lowest.RETRASCORE has further research and clinical application value.