title: Risk stratification in trauma and haemorrhagic shock: scoring systems derived from the TraumaRegister DGU(®).
abstract: Scoring systems commonly attempt to reduce complex clinical situations into one-dimensional values by objectively valuing and combining a variety of clinical aspects. The aim is to allow for a comparison of selected patients or cohorts. To appreciate the true value of scoring systems in patients with multiple injuries it is necessary to understand the different purposes of quantifying the severity of specific injuries and overall trauma load, being: (1) clinical decision making; (2) triage; (3) planning of trauma systems and resources; (4) epidemiological and clinical research; (5) evaluation of outcome and trauma systems, including quality assessment; and (6) estimation of costs and allocation of resources. For the first two, easy-to estimate scores with immediate availability are necessary, mainly based on initial physiology. More sophisticated scores considering age, gender, injury pattern/severity and more are usually used for research and outcome evaluation, once the diagnostic and therapeutic process has been completed. For score development large numbers of data are necessary and thus, it appears as a logical consequence that large registries as the TraumaRegister DGU(®) of the German Trauma Society (TR-DGU) are used to derive and validate clinical scoring systems. A variety of scoring systems have been derived from this registry, the majority of them with focus on hospital mortality. The most important among these systems is probably the RISC score, which is currently used for quality assessment and outcome adjustment in the annual audit reports. This report summarizes the various scoring systems derived from the TraumaRegister DGU(®) over the recent years.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe-University, Frankfurt, Germany. Electronic address: sebastian.wutzler@kgu.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wutzler
authors.affiliation: Institute for Research in Operative Medicine, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany; Department of Orthopedics, Trauma and Sports Medicine, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Maegele
authors.affiliation: Institute for Research in Operative Medicine, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany; Department of Orthopedics, Trauma and Sports Medicine, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany.
authors.forename: Arasch
authors.initials: A
authors.lastname: Wafaisade
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe-University, Frankfurt, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Wyen
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe-University, Frankfurt, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Marzi
authors.affiliation: Institute for Research in Operative Medicine, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
mesh_terms: D054869:Clinical Audit; D003657:Decision Making; D004636:Emergency Service, Hospital; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D009102:Multiple Organ Failure / Q000401:mortality*; D009104:Multiple Trauma / Q000401:mortality*; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care; D012042:Registries; D012307:Risk Factors; D012771:Shock, Hemorrhagic / Q000401:mortality*; D014218:Triage / Q000706:statistics & numerical data
keywords: Mortality; Outcome; Polytrauma; Scoring system