Association between the Japan Coma Scale scores at the scene of injury and in-hospital outcomes in trauma patients: an analysis from the nationwide trauma database in Japan
Autor: | Ryoji Iiduka, Taku Iwami, Yohei Okada, Wataru Ishii, Takeyuki Kiguchi, Kaoru Koike |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Adult
Male Adolescent Databases Factual Eye Movements injury Poison control computer.software_genre Logistic regression Occupational safety and health Young Adult 03 medical and health sciences 0302 clinical medicine Japan Injury prevention Humans Medicine Hospital Mortality Registries Coma Aged Retrospective Studies Aged 80 and over Trauma Severity Indices Database Vital Signs business.industry Research JPTEC Glasgow Coma Scale 030208 emergency & critical care medicine Retrospective cohort study General Medicine Middle Aged prehospital Hospitals Logistic Models JCS Multivariate Analysis Emergency Medicine Female Observational study business computer 030217 neurology & neurosurgery Cohort study |
Zdroj: | BMJ Open |
ISSN: | 2044-6055 |
Popis: | ObjectiveJapan Coma Scale (JCS) is a grading system used to evaluate disturbed consciousness in prehospital care settings. We aimed to identify the association between the JCS levels at the scene with in-hospital mortality, as well as the discrimination ability for the outcomes.DesignA retrospective cohort study based on the nationwide trauma database in Japan.SettingMulticentre cohort study using data from the Japan Trauma Data Bank, which is a nationwide, prospective, observational trauma registry derived from 235 hospitals.ParticipantsAdult trauma victims transferred directly from the scene of injury to the hospital from January 2004 to December 2017 were eligible for inclusion.Primary and secondary outcomesPrimary outcome was the association between the JCS levels at the scene with in-hospital mortality. We conducted a multivariate logistic regression analysis to calculate the adjusted ORs of JCS levels with 95% CIs for in-hospital mortality. We also calculated the c-statistics for in-hospital mortality.Results164 723 patients were included in the analysis. In a multivariate logistic regression analysis, the corresponding adjusted ORs of JCS levels 2 and 3 referred to level 1 for in-hospital mortality were 4.1 (95% CI 3.8 to 4.4) and 26.0 (95% CI 24.8 to 27.2). The c-statistics of the JCS level for in-hospital mortality was 0.845 (95% CI 0.842 to 0.849).ConclusionsData from large multicentre prospective registry revealed strong associations of the JCS level at the scene of injury with in-hospital mortality as well as the good discriminatory performance for this outcome. |
Databáze: | OpenAIRE |
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