ORIGINAL ARTICLE

The usefulness of trauma scores in determining the life threatening condition of trauma victims for writing medical-legal reports

N G Bilgin¹, E Mert², H Çamdeviren³

¹ Mersin University Medical Faculty Hospital, Departments of Forensic Medicine
² Mersin University Medical Faculty Hospital, Departments of Emergency Medicine
³ Mersin University Medical Faculty Hospital, Departments of Biostatistics

Correspondence to:
Correspondence to:
Dr Ertan Mert
Mersin Üniversitesi Tp Fakültesi, Acil Tp A.D. öretim üyesi, Zeytinlibahçe cad., 33079-Mersin, Turkey; drertanmert{at}yahoo.com

Objectives: In the Turkish legal system the severity of the victim’s injury determines the severity of the criminal penalty, and the life threatening condition stated in the medical-legal report is one of the main determinants for injury severity. The aim of this study is to investigate the effectiveness and usefulness of the trauma scores in determining the life threatening condition of trauma victims from the forensic aspect in order to write accurate medical-legal reports.

Methods: Data of 296 forensic cases with blunt and penetrating trauma were obtained. The life threatening condition of patients stated in the medical-legal reports according to the criteria based on traditional forensic opinion were examined. For each case, Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) were calculated. The ROC curve analysis was used to investigate the success of the trauma scores in distinguishing patients with/without life threatening conditions. Logistic regression analysis was performed to measure the association between trauma scores and life threatening conditions.

Results: The relations between all scores and groups (with and without life threatening risk) were found statistically significant. ISS was the most successful method in distinguishing traumatised patients both in a life threatening or non life threatening condition.

Conclusions: Trauma scores can be used for making more objective, standardised, and accurate judgement on whether the injury was a life threatening one or not. These advantages of using trauma scores in such situations will also be helpful for the conclusion of the lawsuits shortly, but further studies are needed to confirm these findings.

Abbreviations: AIS, Abbreviated Injury Scale; FN, negative fraction; FP, positive fraction; ISS, Injury Severity Score; NPV, negative predictive value; PPV, positive predictive value; RTS, Revised Trauma Score; TIS, Turkish Injury Scale; TRISS, Trauma and Injury Severity Score

Keywords: trauma scores; life threatening risk; medical-legal reports; Turkish penalty code 456

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