title: Validation of the Thorax Trauma Severity Score for mortality and its value for the development of acute respiratory distress syndrome.
abstract: BACKGROUND
  The aim of the present study was to evaluate and to validate the Thorax Trauma Severity Score (TTSS) for mortality.
  
  
  METHODS
  By database analysis 712 patients with an injury to the chest admitted to the Universal Medical Center Utrecht between 2000 and 2004 were studied. All patients with a score of ≥1 on the AISthorax were included in the study. The patients' file was evaluated for: TTSS, intensive care unit stay, days on ventilation, thorax trauma-related complications (eg, acute respiratory distress syndrome [ARDS]), total hospital stay, and mortality.
  
  
  RESULTS
  Of the 516 patients included in the study, 140 (27%) developed thorax-related complications. The overall in-hospital mortality rate was 10%. The receiver operating characteristic curve for predicting mortality demonstrated an adequate discrimination by a value of 0.844. The TTSS was statistically significant higher in patients who died of thorax-related complications than in patients who died because of nonthorax-related complications and survivors (P < 0.001, confidence interval [CI] 95%). In patients who developed ARDS the TTSS was significant higher (P = 0.005, CI 95%).
  
  
  CONCLUSIONS
  This study supports the use of the TTSS for predicting mortality in thoracic injury patients. Furthermore, the TTSS appears capable of predicting ARDS.
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht.
authors.forename: Tjeerd S
authors.initials: TS
authors.lastname: Aukema
authors.affiliation: Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Ludo Fm
authors.initials: LF
authors.lastname: Beenen
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht.
authors.forename: Falco
authors.initials: F
authors.lastname: Hietbrink
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht.
authors.forename: Luke Ph
authors.initials: LP
authors.lastname: Leenen
keywords: acute respiratory distress syndrome; mortality; thorax; trauma severity indices; wounds and injuries