Arie Hasiholan Lumban Tobing
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Accuracy of the Chest Trauma Score (CTS) as a Predictor of Acute Respiratory Distress Syndrome (ARDS) in Blunt Chest Trauma Patients: Single Center Study at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia Peter, Billy; Arie Hasiholan Lumban Tobing; Erial Bahar
Sriwijaya Journal of Surgery Vol. 7 No. 2 (2024): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v7i2.104

Abstract

Introduction: Chest trauma is the third most common cause of death due to trauma worldwide, with a mortality rate reaching 60%. Chest Trauma Score (CTS) is a chest trauma assessment score that can predict patient complications and death, including acute respiratory distress syndrome (ARDS). This study aims to determine the relationship and assess the accuracy of CTS as a predictor of ARDS in patients with blunt chest trauma. Methods: Medical records of 32 patients with blunt chest trauma were analyzed. Subjects were assessed for CTS, with components including age, number of rib fractures, presence of bilateral rib fractures, and lung contusion. Data were divided into two groups, CTS<5 and CTS≥5. Data were analyzed to determine the relationship between CTS and ARDS. Results: 62.5% of subjects had CTS ≥5 and 37.5% had CTS<5. As many as 68.8% of subjects with blunt chest trauma experienced ARDS. Analysis using the Fischer Exact Test showed that there was a significant relationship (p<0.05) between the CTS value and ARDS. The sensitivity of this study was 77.3%, specificity 70%, positive predictive value 85%, negative predictive value 58.3%. Conclusion: Statistically there is a significant relationship between the chest trauma score and ARDS, so the chest trauma score is considered accurate as a predictor of ARDS in patients with blunt chest trauma.
The Lung Organ Failure Score (LOFS) as an Early Predictor of Mortality in Blunt Thoracic Trauma: A Preliminary Validation Study in a Southeast Asian Cohort Charita Ulfah Widyawan; Arie Hasiholan Lumban Tobing; Theodorus
Sriwijaya Journal of Surgery Vol. 8 No. 2 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i2.133

Abstract

Introduction: Blunt thoracic trauma is a leading cause of trauma-related mortality. Early and accurate risk stratification is essential for optimizing outcomes, yet many prognostic scores lack validation in diverse populations. This study aimed to perform a preliminary evaluation of the prognostic value of the lung organ failure score (LOFS) for predicting in-hospital mortality in patients with blunt thoracic trauma in an Indonesian tertiary trauma center. Methods: This retrospective, single-center, exploratory cohort study included adult patients (≥18 years) admitted with blunt thoracic trauma to Dr. Mohammad Hoesin General Hospital from January 2023 to January 2025. Data on demographics, injury characteristics, initial physiological parameters, and clinical outcomes were collected. The LOFS was calculated for each patient. The primary outcome was in-hospital mortality. Statistical analyses included bivariate comparisons, Kendall's Tau correlation, and Receiver Operating Characteristic (ROC) curve analysis. Results: A total of 32 patients were included. The overall in-hospital mortality rate was 21.9% (n=7). The non-survivor group had a significantly higher mean LOFS than the survivor group (21.00±5.29 vs. 14.16±3.92, p=0.001). LOFS demonstrated a moderate, positive correlation with mortality (Kendall's Tau r=+0.568, p=0.001). ROC analysis showed that LOFS had excellent discriminative ability for mortality, with an Area Under the Curve (AUC) of 0.840 (95% CI: 0.685–0.995, p=0.001). An optimal cut-off score of ≥18 yielded a sensitivity of 85.7% and a specificity of 80.0%. Conclusion: In this preliminary study, LOFS was strongly associated with in-hospital mortality and demonstrated excellent discriminative performance. The findings suggest LOFS is a promising and simple tool for early risk stratification in this high-risk population. However, the study's small sample size precluded a reliable assessment of its independence from other risk factors. Further validation in larger, prospective multicenter studies is essential to confirm these findings.