The usefulness of trauma scoring systems to differentiate severity of life-threatening injuries in forensic reports

Pursuant to the Turkish Penal Code (TCK), which was adopted on 26 September 2004, rapor situations that endanger a person's life are required to be reported in the reports to be prepared for judicial traumas in our country. Our study was carried out in order to evaluate the trauma scores used for forensic trauma cases according to the recommended guidelines. In the report wgere trauma resulting in death or majör life threatening situation the trauma scoring system is used to compare the impact of the trauma on ones life threatening situation. The data of this study were obtained from retrospective file scans of general forensic and epicrisis reports of people who applied to the court as a result of intentional or negligent injury and who were referred by the judicial authorities to Aydın Adnan Menderes University Practice and Research Hospital between 01 January 2013 and 01 September 2019. Patients who were admitted to the hospital as dead and patients with incomplete trauma file records were excluded. In this study, forensic traumatologic reports of 1684 cases were examined. 1281 (76.1%) cases were male. Mean age of the study was 33 ± 16,716 (range 1-105). In our study, ROC curves were drawn for life-threatening conditions in patients older than 17 years and AIS, ISS, CRAMS, RTS and TRISS values were calculated clinically. Sensitivity 75.6%, selectivity 99.1% for AIS optimal cut point 3, sensitivity 72.6% for ISS optimal cut point 9, selectivity 99%, sensitivity 14.6 for RTS optimal cut point 7,0061, The selectivity was calculated as 99, the sensitivity for CRAMS optimal cut point 8 was 13.5%, the selectivity was 99.9%, for TRISS the most suitable cut point was 93.610, the sensitivity was 23.4% and the selectivity was 99.7%. AIS, ISS, CRAMS, RTS and TRISS values were calculated clinically for life-threatening conditions in patient groups between 0-17 years. Sensitivity 76.1% for AIS optimal cut point 3, selectivity 99.2%, ISS 75% for selective cut point 9, selectivity 99.2%, sensitivity for RTS optimal cut point 7.4745 83.3% , selectivity 85.9%, CRAMS optimal cut point 9 for sensitivity 87.5%, selectivity 86.8%, TRISS optimal cut point 98.95 for sensitivity 95.7%, selectivity 93.7%, PTS optimal The sensitivity for cut-off point 9 was 96.7%, and the selectivity was 97.3%. In the light of the data obtained from our study, it is thought that a standard assessment and scoring system can be used in order to determine the severity of the disease and the likelihood of mortality in traumatized patients, but none of the scoring systems are ideal and need to be constantly updated and especially necessary in terms of standardization.