Correlation Between the Revised Physiological Trauma Score and CT Scan Results

Background Trauma-scoring systems are used to triage patients and assist in clinical decision-making. Physiological trauma scores are used for quantitative evaluation of injury severity. However, only a few, such as the Revised Physiological Trauma Score (rPTS), have been proven effective in pre-clinical use. There is a constant need for clinical decision tools that aim to reduce the unnecessary use of CT scans among trauma patients. To our knowledge, no study has directly correlated the rPTS and CT findings. This study aimed to investigate whether the rPTS is correlated with CT scan results and can be used to decrease the use of CT. Methodology This retrospective chart review examined all patients who underwent a pan-CT for trauma in the Emergency Department of King Abdulaziz Medical City, Jeddah, from 2008 to 2012. Results We analyzed 235 patients. There was a significant difference in the mean rPTS between those with negative versus positive pan-CT scans (11.4 ± 1.3 vs. 10.9 ± 1.7, respectively; p = 0.032). Furthermore, the rate of positive CT scans was significantly higher in those with an rPTS <11 than those with an rPTS of 11 or 12 (87% vs. 74.1%, respectively; p = 0.044). However, 72.7% of patients with an rPTS of 12/12 had a positive pan-CT scan. Conclusions Despite the difference in the frequency of abnormal CT scans, too many patients with normal rPTS had abnormal CT findings. Therefore, the rPTS cannot be used to safely reduce the use of CT scans.