Desempenho do Revised Trauma Score (RTS) como preditor prognóstico de pacientes traumatizados submetidos a cirurgia abdominal de urgência em um hospital universitário – um estudo retrospectivo

Abstract

Introduction: Trauma is a significant public health issue in Brazil, ranking as the 4th leading cause of death in the country. The severity of traumatized patients can be assessed using quantitative and qualitative scales, such as the Revised Trauma Score (RTS). Abdominal traumas, accounting for approximately 10% of all cases, are particularly challenging due to the complexity of the injuries and the frequency of associated traumas. This study aims to evaluate the RTS as a predictor of mortality in patients with abdominal trauma undergoing emergency surgery at a university hospital. Objective: To evaluate the performance of the Revised Trauma Score (RTS) as a predictor of mortality in individuals who underwent surgical procedures on the abdominal cavity at the University Hospital of Lagarto (HUL). Method: This study is a retrospective cohort using secondary data from the Integrated Project entitled "Epidemiology and Factors Associated with Outcome in Patients Undergoing Urgent and Emergency Surgical Procedures." Data were collected from medical records. The RTS was calculated for all patients, and the area under the ROC curve was used to analyze the predictive performance of the RTS. A significance level of 5% (p < 0.05) was adopted for all analyses. Results: The sample consisted of 371 patients who underwent surgeries, including 34 trauma patients, for whom the RTS was calculated. The mean age of the trauma patients was 40.65 years (SD 16.50), with a majority (85.3%) being male. The average length of hospital stay was 11.32 days (SD 12.91). The RTS ranged from 6.37560 to 7.84080, with a mean of 7.77615 and a standard deviation of 0.27751. The analysis of the RTS with the outcome did not show good performance (AUC = 0.414). Conclusion: The RTS demonstrated low predictive performance, suggesting the need for continued study, encompassing not only physiological but also anatomical factors of the patients. Additionally, an increase in the studied sample size is necessary. Furthermore, it is concluded that HUL serves a population of traumatized patients with lower complexity and a high probability of survival. However, it presents a higher mortality rate compared to similar studies.