Mosquera et al developed a score for evaluating a patient with traumatic aortic injury. These can help to identify a patient who may require more aggressive management. The authors are from Complejo Hospitalario Universitario de A Coruna, and Complejo Hospitalario Universitario de Vigo in Spain.
TRAINS = TRaumatic Aortic INjury Score
Patient selection: major trauma patient with blunt chest trauma
Parameters:
(1) widened mediastinum
(2) hypotension
(3) long bone fracture
(4) lung contusion
(5) left scapula fracture
(6) hemothorax
(7) pelvic fracture deformity
|
Parameter |
Finding |
Points |
|
widened mediastinum |
no |
0 |
|
|
yes |
4 |
|
hypotension |
no |
0 |
|
|
yes |
2 |
|
long bone fracture |
no |
0 |
|
|
yes |
2 |
|
lung contusion |
no |
0 |
|
|
yes |
1 |
|
left scapula fracture |
no |
0 |
|
|
yes |
1 |
|
hemothorax |
no |
0 |
|
|
yes |
1 |
|
pelvic fracture deformity |
no |
0 |
|
|
yes |
1 |
total TRAINS =
= SUM(points for all 7 parameters)
Interpretation:
• minimum TRAINS: 0
• maximum TRAINS: 12
• The higher the TRAINS the greater the risk of traumatic aortic injury.
• A score < 4 is associated with a low risk for acute traumatic aortic injury (ATAI).
• A score >= 4 is associated with a high risk of acute traumatic aortic injury.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Cardiology
ICD-10: ,
