External Validation of the Emergency Trauma Score for Early Prediction of Mortality in Trauma Patients
| Autor: | J. Carel Goslings, Niels W. L. Schep, Pieter Joosse, Johannes B. Reitsma, Willem-Jan J. de Jong, Klaus W. Wendt |
|---|---|
| Přispěvatelé: | Other departments, Other Research, Surgery, Amsterdam Movement Sciences |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty MODELS Poison control wounds and injuries Acid-Base Imbalance Critical Care and Intensive Care Medicine Sensitivity and Specificity MULTIPLE IMPUTATION Trauma Centers Risk Factors Injury prevention medicine Humans Glasgow Coma Scale trauma severity indices Intensive care medicine SCALE Retrospective Studies TEAM Coma Prothrombin time validation COAGULOPATHY medicine.diagnostic_test business.industry VALUES Age Factors Retrospective cohort study mortality INJURY SEVERITY SCORE emergencies Emergency medicine Cohort Prothrombin Time Injury Severity Score COMA Female prognosis medicine.symptom business |
| Zdroj: | Critical care medicine, 42(1), 83-89. Lippincott Williams and Wilkins Critical Care Medicine, 42(1), 83-89. LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: | 0090-3493 |
| Popis: | Objectives: The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base excess, and prothrombin time. Our goal was to validate the Emergency Trauma Score in two large external cohorts. As the Injury Severity Score is not accurately known at the time patients present at the resuscitation room, we evaluated the performance of Emergency Trauma Score in all trauma patients.Design: External validation study using data from two prospectively collected trauma registries.Setting: Two academic level 1 trauma centers.Patients: Adult patients admitted to the hospital after treatment at the trauma resuscitation room.Intervention Calibration and discrimination of the original Emergency Trauma Score were assessed within each cohort separately.Measurement and Main Results: A total of 4,418 consecutive patients were evaluated. Discrimination was good in both validation cohorts, with areas under the receiver-operating curve curves that were even higher (0.94 and 0.92, respectively) than that in the original cohort (0.83). Predicted mortality was systematically too high compared with actual mortality in patients with low-to-medium expected risk (Conclusions: The Emergency Trauma Score model performs well in discriminating between trauma patients who will survive and who will not. If applied to all trauma patients, predicted mortality risks are too high in the low-risk category. |
| Databáze: | OpenAIRE |
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