Literature DB >> 15812668

[Age and survival likelihood of polytrauma patients. "Local tailoring" of the DGU prognosis model].

G Matthes1, J Seifert, S Bogatzki, K Steinhage, A Ekkernkamp, D Stengel.   

Abstract

INTRODUCTION: Age is one of five prognostic parameters identified based on data of the trauma registry of the German Association for Trauma Surgery (DGU). We asked ourselves if the suggested prognostic model provides the same predictive power of data from an independent hospital. Furthermore, we investigated whether age itself or age-associated comorbidity causes an unfavorable prognostic effect.
METHODS: The investigation was based on data of 103 multiply injured patients (67 male, 36 female, mean age 35,4+/-SD 19,0 years, ISS 36,8+/-10,9). Data were collected prospectively following the guidelines of the trauma registry of the German Association for Trauma Surgery. Based on documented comorbidities, a risk calculation was performed using the ASA classification. Correlation between age and ASA was analyzed using Spearman's method. The prognostic value of the original model in our patient pool with or without ASA classification, possible interactions, and the discriminatory power of the model were estimated using logistic regression.
RESULTS: Attributable mortality was 31,7% (95% CI 22,7-41,7%). Age, ISS, GCS and ASA were included into the final logistic model. Odds ratios of the origin model were reproducible nearly identical in our patinet pool (OR: age 1,048; ISS 1,066; GCS 0,822). In spite of the fact that we have found a strong correlation between age and ASA-Classification (rho=0,60, p<0,0001) there was no prognostic value of comorbidity.
CONCLUSION: The suggested prognostic model based on multicenter data evaluation can be applied to a single center with only minimal loss of discriminatory power. In this context, age seems to have a prognostic value independent of comorbidity.

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Year:  2005        PMID: 15812668     DOI: 10.1007/s00113-005-0929-9

Source DB:  PubMed          Journal:  Unfallchirurg        ISSN: 0177-5537            Impact factor:   1.000


  28 in total

Review 1.  Prognostic models in medicine. AI and statistical approaches.

Authors:  A Abu-Hanna; P J Lucas
Journal:  Methods Inf Med       Date:  2001-03       Impact factor: 2.176

2.  The Major Trauma Outcome Study: establishing national norms for trauma care.

Authors:  H R Champion; W S Copes; W J Sacco; M M Lawnick; S L Keast; L W Bain; M E Flanagan; C F Frey
Journal:  J Trauma       Date:  1990-11

3.  Geriatric trauma: outcomes of elderly patients discharged from the ED.

Authors:  P C Ferrera; J M Bartfield; C C D'Andrea
Journal:  Am J Emerg Med       Date:  1999-11       Impact factor: 2.469

4.  Origin of the ASA classification.

Authors:  R Ament
Journal:  Anesthesiology       Date:  1979-08       Impact factor: 7.892

Review 5.  [Management of polytrauma patients in an international comparison].

Authors:  H J Oestern
Journal:  Unfallchirurg       Date:  1999-02       Impact factor: 1.000

6.  The ASA classification of physical status--a recapitulation.

Authors:  A S Keats
Journal:  Anesthesiology       Date:  1978-10       Impact factor: 7.892

7.  A review of goodness of fit statistics for use in the development of logistic regression models.

Authors:  S Lemeshow; D W Hosmer
Journal:  Am J Epidemiol       Date:  1982-01       Impact factor: 4.897

8.  Evaluating trauma care: the TRISS method. Trauma Score and the Injury Severity Score.

Authors:  C R Boyd; M A Tolson; W S Copes
Journal:  J Trauma       Date:  1987-04

9.  [Predicting the outcome in severe injuries: an analysis of 2069 patients from the trauma register of the German Society of Traumatology (DGU)].

Authors:  D Rixen; M Raum; B Bouillon; L E Schlosser; E Neugebauer
Journal:  Unfallchirurg       Date:  2001-03       Impact factor: 1.000

Review 10.  Preoperative assessment and preparation.

Authors:  K E Griffith
Journal:  Int Anesthesiol Clin       Date:  1994
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  7 in total

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Journal:  World J Surg       Date:  2009-11       Impact factor: 3.352

4.  [Changes in geriatric traumatology. An analysis of 14,869 patients from the German Trauma Registry].

Authors:  S Wutzler; R Lefering; H L Laurer; F Walcher; H Wyen; I Marzi
Journal:  Unfallchirurg       Date:  2008-08       Impact factor: 1.000

5.  Enhanced pro-inflammatory response and higher mortality rates in geriatric trauma patients.

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Journal:  Eur J Trauma Emerg Surg       Date:  2019-12-24       Impact factor: 3.693

6.  Protocol for a randomized controlled trial on risk adapted damage control orthopedic surgery of femur shaft fractures in multiple trauma patients.

Authors:  Dieter Rixen; Eva Steinhausen; Stefan Sauerland; Rolf Lefering; Matthias Meier; Marc G Maegele; Bertil Bouillon; Edmund A M Neugebauer
Journal:  Trials       Date:  2009-08-19       Impact factor: 2.279

7.  Randomized, controlled, two-arm, interventional, multicenter study on risk-adapted damage control orthopedic surgery of femur shaft fractures in multiple-trauma patients.

Authors:  Dieter Rixen; Eva Steinhausen; Stefan Sauerland; Rolf Lefering; Marc G Maegele; Bertil Bouillon; Guido Grass; Edmund A M Neugebauer
Journal:  Trials       Date:  2016-01-25       Impact factor: 2.279

  7 in total

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