Evaluation scales for determining the severity of the condition in polytrauma
https://doi.org/10.17238/2072-3180-2022-4-97-104
Abstract
Introduction. Polytrauma is a collective concept that includes multiple and combined, combined injuries that pose a danger to the life or health of the victim and require emergency medical care. Injury occupies one of the leading places in the structure of mortality among the working population in peacetime, and is one of the main causes of death in military conflicts. The polymorphic nature of injuries and the lack of a unified view on the assessment of the severity of the condition are the key problems of this topic. Together, the available scales answer all the main diagnostic questions, but have limitations in terms of speed and ease of use. This article presents an analysis of the main prognostic scales used to diagnose surgical patients with polytrauma.
Conclusion. At the moment, there are many diagnostic scales for assessing the severity of the condition of patients with severe injuries. Some of them and combinations of scales have proven themselves to be the most predictably significant. A group of Russian authors has developed their own diagnostic scale, with the experience of successful practical application.
About the Authors
D. V. Nikolaev
Evdokimov Moscow state medical University; REAVIZ medical university
Russian Federation
Russian Federation
Nikolaev Dmitry Vladimirovich – surgeon; assistant of Department of Hospital surgery; Senior lecturer
127473, Moscow, 20/1 Delegatskaya str.;
107564, Moscow, Krasnobogatyrskaya st., 2, building 2, entrance 22
O. V. Dyakova
REAVIZ medical university
Russian Federation
Russian Federation
Diakova Olga Vladimirovna – student
107564 Moscow, Krasnobogatyrskaya st., 2, building 2, entrance 22
V. S. Fomin
Evdokimov Moscow state medical University; Veresaev City Clinical Hospital
Russian Federation
Russian Federation
Fomin Vladimir Sergeevich – MD, PhD, Associate Professor; surgeon of the V.V. Veresaev City Clinical Hospital
127644, Moscow, st. Lobnenskaya, 10
References
1. Aghajanyan V.V. Arrangement of medical assistance for multiple and associated injuries (polytrauma) The clinical recommendations (the treatment protocol) (the project). Polytrauma, 2015, № 4, pp. 6–18. (In Russ.)
2. Apartsin K.A. Combined trauma surgery Siberian Medical Journal (Irkutsk), 2014, № 3, pp. 129–133. (In Russ.)
3. Apartsin K.A., Vasilyeva N.E., Novozhilov A.V. Evaluation of severity of shocking trauma in acute period of traumatic disease. Clinical medicine, 2007, № 2(54), pp. 15–18. (In Russ.)
4. Berezka N.I., Litovchenko V.A., Garyachiy E.V., Lapshin D.V., Morozova Yu.V. Optimization of surgical tactics for the treatment of polytrauma victims using scales for assessing the severity of the condition and injuries. Scientific Bulletin, Medicine, Pharmacy series, 2014, № 4(175), Issue 25, pp. 116–119. (In Russ.)
5. Boyko I.V., Zaft V.B., Lazarenko G.O., Zaslavsky A.Yu. Organization of emergency medical care for victims with polytrauma at the stages of medical evacuation. Emergency medicine, 2013, № 2 (49), pp. 77–84. (In Russ.)
6. Grigoriev E.V., Lebedinsky K.M., Shchegolevsky A.V., Bobovnik S.V., Bulanov A.Yu., Zabolotskikh I.B., Sinkov S.V., Shen N.P., Kornelyuk R.A. Resuscitation and intensive care in acute massive blood loss in adult patients. Clinical recommendations. Anesthesiology and Resuscitation, 2020, № 1, pp. 5–24. (In Russ.)
7. Gumanenko E.K. War surgery, 2nd edition. M. : GEOTAR-Media, 2008. 768 p. (In Russ.)
8. Dubrov V.E., Blazhenko A.N., Khanin M.Yu., Gorbunov I.A., Blazhenko A.A., Kobritsov G.P., Khashagulgov G.M. Implementation of the principle of dynamic damage control damage control in the acute period of polytrauma. Polytrauma, 2012, № 2, pp. 68–73. (In Russ.)
9. Dubrov V.E., Koltovich A.P., Paltyshev A.P. Evaluation of tactic Damage control surgery in the treatment of combined thermo–mechanical injuries. Traumatology, 2013, Jan 30, Vol. 14, pp. 88–102. (In Russ.) http://www.medline.ru
10. Ermolaeva N. K., Maskin S. S., Bosko O. Yu., Alexandrov V. V., Tajieva A. R. Lethality structure and error analysis in combined closed abdominal trauma. Kuban Scientific Medical Bulletin, 2013, № 7, pp. 177–181. (In Russ.)
11. Giannou K, Baldan M. War surgery. Working with limited resources in armed conflict and other situations of violence. International Committee of the Red Cross (ICRC), Russian version prepared by the ICRC Regional Information Center in Moscow (CSC EAST), 2010, Oct, Vol. 1. (In Russ.)
12. Kobelyatsky Yu.Yu., Yovenko I.A., Tsarev A.V., Kuzmova E.A., Perederiy M.N., Zaslavsky A.Yu. Intensive therapy of polytrauma from the perspective of modern international recommendations. Emergency medicine, 2013, № 7(54), pp. 10–14. (In Russ.)
13. Korzhuk M.S., Kozlov K.K., Chernenko S.V., Yudakova T.N., Khamanov A.R. The main provisions of the damage control approach in polytrauma. Omsk Scientific Bulletin, 2015, № 1, pp. 53–57. (In Russ.)
14. Kotelnikov G.P., Trukhanova I.G., Shabanova A.Yu. Polytrauma – definition, tactics, therapeutic measures. Emergency medical care, 2014. (In Russ.) https://onmedrus.ru/lechebnye-meropriyatiya.html
15. Krainukov P.E., Samohvalov I.M., Reva V.A. Tactical medicine – new conception for «new types» war. Military medical magazine, 2021, Vol. 342, № 5, pp.4–17 (In Russ.)
16. Krishtafor A.A., Zaslavsky A.Yu. Assessment of the severity of stress response to combat injuries as an element of monitoring the patient’s condition in the intensive care unit. Emergency Medicine, 2015, V.A. 5(68), pp. 112-117. (In Russ.)
17. Malyshev V.E. Pathogenetic and diagnostic significance of hematopoiesis and immunity disorders in the development of complications of combined trauma. Abstract of the dissertation for the degree of Doctor of Biological Sciences St. Petersburg, 2014. 33 p.
18. Miziev I.A., Zhigunov A.K., Baksanov H.D., Akhkubekov R.A., Berov R.B., Dabagov O.Yu., Soltanov E.I., Dyshekova F.A. Hospital mortality in combined injury and the ways of its reduction. Health and education in the XXI century, 2018, Vol. 20, № 12, pp. 116–119. (In Russ.)
19. Mukhanov M.L. Features of dynamic damage control in polytrauma in elderly victims. Abstract dissertation for the degree of Candidate of Medical Sciences, Publishing and Printing Center of KubGU, Krasnodar, 2018. 24 p.
20. Plekhanov A.N., Nomokonov I.A., Shagdurov V.A. Organizational and tactical aspects of rendering assistance for patients with concomitant injury in current conditions. Report 2. Polytrauma, 2008, № 1, pp. 59–63. (In Russ.)
21. Seliverstov P.A., Shapkin Yu.G. Assessment of the Severity and Prognosis of Politrauma Outcome: the Current State of the Problem (Review). Modern technologies in medicine, 2017, Volume 9, № 5, pp. 207–218. (In Russ.)
22. Semenov A.V., Sorokovikov V.A. The scales for estimation of injury severity and predicting of outcomes of injuries. Polytrauma, 2016, № 2, pp. 80–90. (In Russ.)
23. Sokolov V.A. Demage control – a modern concept of treatment of victims with critical polytrauma. Bulletin of Traumatology and Orthopedics named of N.N. Priorov, 2005, № 1, pp. 81–84. (In Russ.)
24. Guidelines for war surgery, ed. Belskikh A.N., Samokhvalova, Ministry of Defense of the Russian Federation, 2013, 474 p. (In Russ.)
25. Khadjibaev A.M., Mustafakulov I.B. Integral evaluation systems of severe patients condition with combined abdominal injuries. Bulletin of Emergency Medicine, 2012, № 3. pp. 73–78. (In Russ.)
26. Khadjibaev A.M., Mustafakulov I.B. Present condition and unsolved problems of diagnostics and tactics in treatment of severe abdominal injuries in combined injury. Shoshilinch tibbiyot axborotnomasi, 2011, № 4, pp. 77–81. (In Russ.)
27. Shapkin Yu. G., Seliverstov P. A., Skripal E. A., Kochetov Yu. V., Gavrilov A.V. Risk factors for the mortality caused by severe combined traumas with skeletal injuries. News of higher educational institutions. Volga Region, 2017, № 2(42), pp. 94–104. (In Russ.)
28. Shapkin Yu.G., Seliverstov P.A. The phenomenon of mutual aggravation of injuries in polytrauma. Perm Medical Journal, 2016, Vol. 33, № 5, pp. 82–94. (In Russ.)
29. Shapkin Yu.G., Seliverstov P.A., Skripal E.A. The phenomenon of the “second hit” after operations of osteosynthesis in case of polytrauma. Russian Medical Journal, 2017, № 23(6), pp.331–336. (In Russ.)
30. Shaposhnikov R.A. Tactics of "damage control" in the treatment of abdominal trauma. Abstract of the dissertation for the degree of Candidate of Medical Sciences. Moscow, 2009. 26 p.
31. Shatalin A.V., Aghajanyan V.V., Kravtsov S.A., Skopintsev D.A. Medical transportation for patients with polytrauma. Polytrauma, 2008, № 1, pp.24–31. (In Russ.)
32. Shevchenko Y.L., Bryusov P.G., Levchuk A.L. Traumatic illness and modern surgical tactics in combined gunshot thoracospinal wounds. Bulletin of N.I. Pirogov National Medical-Surgical Center, 2006, Vol. 1, № 1, pp. 81–85. (In Russ.)
33. Shukurbaev K.A., Aralbayev T.A., Aytaliev T.D. Lethality in polytrauma patients. Medicine of Kazakhstan, 2012, May, № 3, pp. 113–115. (In Russ.)
34. Shchegolev A.A., Tovmasyan R.S., Chevokin A.Yu., Muradyan T.G., Plotnikov V.V. Tertiary peritonitis – the state of the problem and possible prospects. General Medicine, 2018. № 4, pp. 32–35. (In Russ.)
35. Ergashev O.N., Makhnovsky A.I., Krivonosov S.I. Prognosis of the acute phase course of traumatic disease and transportability in polytrauma patients. Bulletin of Surgery, 2018, pp. 45–48. (In Russ.)
Review
For citations:
Nikolaev D.V., Dyakova O.V., Fomin V.S. Evaluation scales for determining the severity of the condition in polytrauma. Moscow Surgical Journal. 2022;(4):97-104. (In Russ.) https://doi.org/10.17238/2072-3180-2022-4-97-104
Views:
709
Email this article 