Predictors of morbidity and mortality in blunt abdominal trauma: The TRAFIC score

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Cairo University, Giza, Egypt.

Abstract

Background: Blunt abdominal trauma (BAT) is a frequent reason for hospital admission and a significant cause of death.
Many scoring systems are designed to predict management outcomes. However, it is challenging because many variables
affect the prognosis of trauma patients. The study aimed to create a simple score for prediction of morbidity and mortality in BAT which could be applied without the need for complex mathematical equations based upon initial physiological parameters, imaging, and response to initial resuscitation.
Patients and Methods: This prospective observational cohort study included patients who presented to Kasr Alainy
emergency unit with BAT during the period from December 2020 to April 2021. Data obtained included socio-demographic data, assessment using advanced trauma life support, imaging findings, definitive management, and outcome. Logistic regression was done for selected statistically significant factors forming the BAT score.
Results: A total of 193 patients admitted for conservative/operative management following BAT were studied. The
incidence of morbidity and mortality was 26.9 and 5.7%, respectively. Significant predictors for morbidity and mortality
to BAT (Mnemonic: TRAFIC score) included: (T) trauma associated severe hemorrhage score greater than 10, (R)
Response to fluid therapy, (A) positive abdominal examination, (F) positive FAST for moderate or marked amount of
intra-abdominal free fluid collection (more than 500cc), (I) ICU admission, (C) positive compute tomography findings,
Consciousness (Low glasgow coma score), Circulation (hemodynamic instability). A score of more than 5 is highly
suggestive of morbidity, and a score of more than 6 is highly suggestive of mortality.
Conclusion: TRAFIC’ is a simple score that can predict the morbidity and mortality in BAT. However, more studies are
needed to validate the score.

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