Can trauma scores predict the length of hospital stay of patients with fractures after earthquake-related blunt injury?

Abstract

Objective

The number of patients during disastrous conditions was high, and triage is essential. In chaotic circumstances, orthopedic surgeons can also struggle with patient selection, not only for surgical selection but also for the necessity of hospitalization. So, the performance of the Injury Severity Score, New Injury Severity Score, and Trauma and Injury Severity Score was compared in victims who were struck under the wreckage and had fractures due to the Kahramanmaras Earthquake.

Material and Methods

The study included 147 patients. Patients younger than 18, lacking information that prevents calculation of trauma scores, having a history of fracture other than struck injury, and those who didn't survive the follow up were not included in the study. Fractures were classified as anatomic regions. The relationship between the trauma scores, fracture regions, entrapment durations, and length of hospital stay was evaluated. Other risk factors related to length of stay were also determined.

Results

The age and gender of the patients did not affect the length of hospital stay. There was no relationship between the fracture region and length of stay. Even the proximal fractures of the upper extremities had significantly shorter hospitalization duration. Entrapment duration was correlated considerably with length of stay (p < 0.001). NISS, ISS, and NISS were correlated with length of stay (p < 0.001, p < 0.001, p = 0.033), and the AUC values of the trauma scores were 0.70, 0.66, and 0.59, respectively. Multiple regression analysis showed that only NISS and entrapment duration was related to length of stay, while ISS and TRISS were not.

Conclusion

All the trauma scores can assess expected length of hospital stay for patients with fractures; however, NISS shows better predicting performance. Additionally, the fracture location is not associated with the length of stay.