Validation of the new proposed Emergency Trauma Score (EMTRAS)

Introduction

Recently, Raum and colleagues [1] generated and validated a new trauma score (Emergency Trauma Score, EMTRAS) based on age, prehospital GCS, prothrombin time and base excess. Each parameter is subdivided into four classes, scored from 0 to 3 points. Scores of each class are summed to obtain the EMTRAS, ranging from 0 to 12. Here we present preliminary results of a study with the aim to validate this new scoring system and to compare it with other commonly used illness scores.

Methods

One hundred and fifty trauma patients admitted to the regional referral trauma center (Careggi Teaching Hospital, Florence, Italy) were studied. Predictive value of the EMTRAS score was compared with the Injury Severity Score (ISS), Revised Trauma Score (RTS), Trauma Injury Severity Score (TRISS) and Simplified Acute Physiology Score (SAPS) II. Logistic regression analysis was performed with MedCalc version 10 (MedCalc Software, Mariakerke, Belgium).

Results

The areas under the curves confirmed a good reliability of the EMTRAS score if compared with other validated trauma scores and with nontrauma-specific scores such as SAPS II (Table 1). In particular, patients with EMTRAS scores of 5, 6 and 7 had a more major risk of death (odds ratio) of 2.3, 4 and 16, respectively, than patients with EMTRAS score below 5.

Table 1 Area under the curve (AUC) for EMTRAS and other scoring systems

Conclusions

Our preliminary results confirm that EMTRAS has a good correlation with mortality risk. All four parameters of the score are simply available in a small amount of time, allowing physicians to quickly estimate trauma patients' severity, before other examinations like CT scan are performed.