Mortality prediction using TRISS methodology in the Spanish ICU Trauma Registry (RETRAUCI)
| Autor: | M. Sánchez-Casado, E. Tejerina-Alvarez, J.F. Fernández-Ortega, Juan José Egea-Guerrero, J. Roldán-Ramírez, F. Alberdi-Odriozola, M.D. Mayor-García, M.Á. Ballesteros-Sanz, M. Chico-Fernández, L. Servià-Goixart, F. Guerrero-López, J.A. Llompart-Pou, J. González-Robledo, Francisca Pino-Sánchez, A. Bueno-González, J. Homar-Ramírez |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Poison control Trauma registry macromolecular substances Critical Care and Intensive Care Medicine law.invention 03 medical and health sciences 0302 clinical medicine law Predictive Value of Tests Intensive care medicine Humans 030212 general & internal medicine Hospital Mortality Prospective Studies Registries Trauma Severity Indices Receiver operating characteristic business.industry Mortality rate 030208 emergency & critical care medicine medicine.disease Intensive care unit Surgery Intensive Care Units ROC Curve Blunt trauma Spain Emergency medicine Injury Severity Score business Penetrating trauma |
| Zdroj: | Medicina intensiva. 40(7) |
| ISSN: | 1578-6749 |
| Popis: | Objectives To validate Trauma and Injury Severity Score (TRISS) methodology as an auditing tool in the Spanish ICU Trauma Registry (RETRAUCI). Design A prospective, multicenter registry evaluation was carried out. Setting Thirteen Spanish Intensive Care Units (ICUs). Patients Individuals with traumatic disease and available data admitted to the participating ICUs. Interventions Predicted mortality using TRISS methodology was compared with that observed in the pilot phase of the RETRAUCI from November 2012 to January 2015. Discrimination was evaluated using receiver operating characteristic (ROC) curves and the corresponding areas under the curves (AUCs) (95% CI), with calibration using the Hosmer–Lemeshow (HL) goodness-of-fit test. A value of p Main variables of interest Predicted and observed mortality. Results A total of 1405 patients were analyzed. The observed mortality rate was 18% (253 patients), while the predicted mortality rate was 16.9%. The area under the ROC curve was 0.889 (95% CI: 0.867–0.911). Patients with blunt trauma ( n = 1305) had an area under the ROC curve of 0.887 (95% CI: 0.864–0.910), and those with penetrating trauma ( n = 100) presented an area under the curve of 0.919 (95% CI: 0.859–0.979). In the global sample, the HL test yielded a value of 25.38 ( p = 0.001): 27.35 ( p p = 0.658) in penetrating trauma. TRISS methodology underestimated mortality in patients with low predicted mortality and overestimated mortality in patients with high predicted mortality. Conclusions TRISS methodology in the evaluation of severe trauma in Spanish ICUs showed good discrimination, with inadequate calibration – particularly in blunt trauma. |
| Databáze: | OpenAIRE |
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