Raum et al reported the Emergency Trauma Score (EMTRAS) for early estimation of trauma severity. The score can help to identify a patient who may benefit from more aggressive management. The authors are from the Polytraums Study Group of the German Trauma Society.
Patient selection: adult trauma patients
Parameters were selected that could be available within 30 minutes of arrival.
Parameters:
(1) age in years
(2) Glasgow Coma Score
(3) base excess in mmol/L (the more negative the number the greater the metabolic acidosis)
(4) percent prothrombin activity
Parameter |
Finding |
Points |
age in years |
< 40 years |
0 |
|
40 to 60 years |
1 |
|
61 to 75 years |
2 |
|
> 75 years |
3 |
Glasgow Coma Score |
13 to 15 |
0 |
|
10 to 12 |
1 |
|
6 to 9 |
2 |
|
3 to 5 |
3 |
base excess |
> -1 |
0 |
|
-1 to -5 |
1 |
|
-5.1 to -10 |
2 |
|
< -10 |
3 |
prothrombin activity |
> 80% (normal) |
0 |
|
50 to 80% |
1 |
|
20 to 49% |
2 |
|
< 20% |
3 |
where:
• The prothrombin activity can be estimated from a curve plotting prothrombin time versus percent activity.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the more severe the trauma.
Performance:
• The area under the ROC curve was 0.83.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general