Hildebrand et al reported the PolyTrauma Grading Score (PTGS) for evaluating a patient with polytrauma. This can help to identify a patient who may require more aggressive management. The authors are from Aachen University, IFOM Cologne, University of Texas Health Science Center San Antonio and Royal Bolton Foundation NHS Trust.
Patient: age > 16 years, ISS >= 16, AIS abdomen or AIS chest >= 3, treatment in ICU
Parameters:
(1) admission systolic blood pressure in mm Hg
(2) base deficit in mmol/L
(3) INR
(4) NISS
(5) number of units of packed red blood cells
(6) platelet count
Parameter |
Finding |
Points |
systolic blood pressure |
> 90 mm Hg |
0 |
|
76 to 90 mm Hg |
1 |
|
< 76 mm Hg |
2 |
base deficit |
< 8 mmol/L |
0 |
|
8 to 10 mmol/L |
2 |
|
> 10 mmol/L |
4 |
INR |
< 1.4 |
0 |
|
1.4 to 2.0 |
1 |
|
> 2.0 |
3 |
NISS |
< 35 |
0 |
|
35 to 49 |
3 |
|
>= 50 |
4 |
packed RBCs |
< 3 units |
0 |
|
3 to 14 units |
2 |
|
>= 15 |
5 |
platelet count |
>= 150,000 per µL |
0 |
|
< 150,000 per µL |
2 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the greater the in-hospital mortality.
Total Score |
Condition |
In-Hospital Mortality |
0 to 5 |
stable |
2-8% |
6 to 11 |
borderline |
13 to 23% |
12 to 19 |
unstable |
48 to 88%% |
20 |
unstable |
100% |
Specialty: Surgery, orthopedic, Emergency Medicine