Development and validation of a new simplified anatomic trauma mortality score
| Autor: | Affirul Chairil Ariffin, Razman Jarmin, Rizal Imran Alwi, Jih Huei Tan, Yuzaidi Mohamad, Chor Lip Henry Tan |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Logistic regression 03 medical and health sciences 0302 clinical medicine Injury Severity Score Chart Medicine Humans Glasgow Coma Scale Hospital Mortality Registries Program Development General Environmental Science 030222 orthopedics Univariate analysis Trauma Severity Indices Receiver operating characteristic business.industry Malaysia 030208 emergency & critical care medicine Middle Aged medicine.disease Blood pressure ROC Curve Pelvic fracture General Earth and Planetary Sciences Wounds and Injuries Female Radiology Triage business Emergency Service Hospital Trauma surgery |
| Zdroj: | Injury. 50(5) |
| ISSN: | 1879-0267 |
| Popis: | Background Most trauma mortality prediction scores are complex in nature. GAP (Glasgow Coma Scale, Age, Systolic blood pressure) and mGAP (mechanism, Glasgow Coma Scale, Age, Systolic blood pressure) scores are relatively simple scoring tools. However, these scores were not validated in low and middle income countries including Malaysia and its accuracies are influenced by the fluctuating physiologic parameters. This study aims to develop a relevant simplified anatomic trauma scoring system for the local trauma patients in Malaysia. Method A total of 3825 trauma patients from 2011 to 2016 were extracted from the Hospital Sultanah Aminah Trauma Surgery Registry. Patients were split into a development sample (n = 2683) and a validation sample (n = 1142). Univariate analysis is applied to identify significant anatomic predictors. These predictors were further analyzed using multivariable logistic regression to develop the new score and compared to existing score systems. The quality of prediction was determined regarding discrimination using sensitivity, specificity and receiver operating characteristic [ROC] curve. Results Existing simplified score systems (GAP & mGAP) revealed areas under the ROC curve of 0.825 and 0.806. The newly developed HeCLLiP (Head, cervical spine, lung, liver, pelvic fracture) score combines only five anatomic components: injury involving head, cervical spine, lung, liver and pelvic bone. The probabilities of mortality can be estimated by charting the total score points onto a graph chart or using the cut-off value of (>2) with a sensitivity of 79.2 and specificity of 70.6% on the validation dataset. The HeCLLiP score achieved comparable values of 0.802 for the area under the ROC curve in validation samples. Conclusion HeCLLiP Score is a simplified anatomic score suited to the local Malaysian population with a good predictive ability for trauma mortality. |
| Databáze: | OpenAIRE |
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