Ani, Noor Hafiza Che
(2017)
Comparison of Triage Revised Score and CRAMS Scale as predictors of outcome for adult trauma patient in Emergency Department, Hospital Universiti Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
INTRODUCTION: Trauma is an important health problem and a leading cause of death
among young adults. Early recognition of injury severity could aid in managing trauma
patient. Triage scores that capable to predict outcome would give better assessment of patient
urgency to get proper treatment at trauma center.
OBJECTIVE: To compare the utility of Triage Revised Trauma Score (T-RTS) with
CRAMS Scale in determining outcome of adult trauma patient in Emergency Department
(ED), Hospital Universiti Sains Malaysia (HUSM).
METHODS: A Prospective cohort study that was conducted within three months study
period from December 2015 until February 2016 by assessing adult trauma patients at triage
and their disposition from ED.
RESULT: 91 patients were recruited. For T-RTS, 12 patients (13.2%) were score as major,
and 79 patients (86.8%) were scored as minor (median=12, IQR=0). For CRAMS, 10 patients
(11.0%) were scored as major, and 81 patients (89.0%) were scored as minor (median-=10,
IQR=1). T-RTS sensitivity is 71.4% while CRAMS Scale sensitivity is 72.4 %. CRAMS
score have higher specificity 94.0% compare to T-RTS specificity 91.7%. Both scoring
system have high negative predictive value, 97.5%. CRAMS Scale had higher positive
predictive value compared to T-RTS (50.0% and 41.7% respectively).
CONCLUSION: Our study showed CRAMS Scale was better than T-RTS in predicting
patient outcome from ED. Further study needed to be done with larger sample size and longer
duration in order to improve the reliability of the study.
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