The modified rapid emergency medicine score: A trauma triage tool to predict in-hospital mortality in Hatyai hospital

Abstract

Introduction : The effective trauma care would reduce mortality rate which associate with injury severity. An accurate trauma severity score has advantage to prioritize responses and resources in emergency room. Currently Hatyai hospital is using TRISS to predict probability of survival which need many variables to calculate and difficult to evaluate in emergency room. We aim to test a novel trauma triage tool, the modify Rapid Emergency Medicine Score (mREMS), since It can predict in-hospital mortality rate compare to TRISS to evaluate severity of traumatic patient.

Objectives : The objective was to test mREMS accuracy as a predictor of in-hospital mortality when compared to the Trauma Score – Injury Severity Score (TRISS).

Methods : The research comprised validating the modified REM score retrospectively in Hatyai hospital that included 2,104 patients admitted with trauma in 2017. The discriminate power of mREMS was compared to TRISS using the area under the receiver operating characteristic curve (AUC).

Results : Higher mREMS was associated with increased mortality (p-value < 0.0001). The mREMS with an AUC of 0.934 (95% CI: 0.898–0.971) was demonstrated to be higher than RTS (AUC 0.888 [95% CI: 0.816–0.961]) and ISS (AUC 0.8790 [95% CI 0.817–0.941]) but lower than TRISS (AUC 0.940 [95% CI: 0.902–0.978]) in predicting in-hospital mortality in Hatyai hospital.

Conclusions : In the trauma patients, mREMS is an accurate predictor of in-hospital mortality. Simple and objective, mREMS may hold value in the pre-hospital and emergency room setting in order to guide trauma team responses.