BACKGROUND: In the Trauma Audit and Research Network (TARN), currently the largest trauma network in Europe, outcome prediction is performed using the TRISS methodology since 1989. Its database contains 200,000 hospital admissions from 110 hospitals over the country, but a large amount of data is lost for the modelling because of missing data. To improve some of the shortcomings of TRISS a new model was developed. METHODS: The data for modelling consisted of 100,399 hospital trauma admissions over the period 1996 to 2001. Using the Glasgow Coma Score (GCS) instead of RTS has dramatically reduced the number of missing cases. Gender and its interaction with age have also been included in the model. The model was tested on different subsets of cases traditionally excluded, such as children, those with penetrating injuries, and ventilated and transferred patients. The new model included all those subsets using age, a transformation of ISS, GCS, gender and gender by age interaction as predictors. RESULTS: The model has shown a good discriminant ability tested by the area under the receiver operating characteristic (AROC) curve. The values of the AROC for the new model were 0.947 (95% CI: 0.943-0.951) on the prediction set and 0.952 (95% CI: 0.946-0.957) on the validation set compared respectively with 0.937 (95% CI: 0.932-0.943) and 0.941 (95% CI: 0.936-0.952) for TRISS. CONCLUSION: The new model has enabled us to include most of the cases that were excluded under the TRISS's inclusion criteria, less missing data are incurred and the predictive performance was significantly better than that of the TRISS model as shown by the AROC curves.
BACKGROUND: In the Trauma Audit and Research Network (TARN), currently the largest trauma network in Europe, outcome prediction is performed using the TRISS methodology since 1989. Its database contains 200,000 hospital admissions from 110 hospitals over the country, but a large amount of data is lost for the modelling because of missing data. To improve some of the shortcomings of TRISS a new model was developed. METHODS: The data for modelling consisted of 100,399 hospital trauma admissions over the period 1996 to 2001. Using the Glasgow Coma Score (GCS) instead of RTS has dramatically reduced the number of missing cases. Gender and its interaction with age have also been included in the model. The model was tested on different subsets of cases traditionally excluded, such as children, those with penetrating injuries, and ventilated and transferred patients. The new model included all those subsets using age, a transformation of ISS, GCS, gender and gender by age interaction as predictors. RESULTS: The model has shown a good discriminant ability tested by the area under the receiver operating characteristic (AROC) curve. The values of the AROC for the new model were 0.947 (95% CI: 0.943-0.951) on the prediction set and 0.952 (95% CI: 0.946-0.957) on the validation set compared respectively with 0.937 (95% CI: 0.932-0.943) and 0.941 (95% CI: 0.936-0.952) for TRISS. CONCLUSION: The new model has enabled us to include most of the cases that were excluded under the TRISS's inclusion criteria, less missing data are incurred and the predictive performance was significantly better than that of the TRISS model as shown by the AROC curves.
Authors: Kawu A Ahidjo; Salami A Olayinka; Olawepo Ayokunle; Alimi F Mustapha; Gbadegesin A A Sulaiman; Adebule T Gbolahan Journal: J Spinal Cord Med Date: 2011 Impact factor: 1.985
Authors: Ida Füglistaler-Montali; Corinna Attenberger; Philipp Füglistaler; Augustinus L Jacob; Felix Amsler; Thomas Gross Journal: World J Surg Date: 2009-11 Impact factor: 3.352
Authors: Hideo Tohira; Ian Jacobs; David Mountain; Nick Gibson; Allen Yeo Journal: Scand J Trauma Resusc Emerg Med Date: 2012-09-10 Impact factor: 2.953
Authors: Kjetil G Ringdal; Timothy J Coats; Rolf Lefering; Stefano Di Bartolomeo; Petter Andreas Steen; Olav Røise; Lauri Handolin; Hans Morten Lossius Journal: Scand J Trauma Resusc Emerg Med Date: 2008-08-28 Impact factor: 2.953
Authors: Thomas Brockamp; Marc Maegele; Christine Gaarder; J Carel Goslings; Mitchell J Cohen; Rolf Lefering; Pieter Joosse; Paal A Naess; Nils O Skaga; Tahnee Groat; Simon Eaglestone; Matthew A Borgman; Philip C Spinella; Martin A Schreiber; Karim Brohi Journal: Crit Care Date: 2013-07-11 Impact factor: 9.097
Authors: Ting Hway Wong; Gita Krishnaswamy; Nivedita Vikas Nadkarni; Hai V Nguyen; Gek Hsiang Lim; Dianne Carrol Tan Bautista; Ming Terk Chiu; Khuan Yew Chow; Marcus Eng Hock Ong Journal: Scand J Trauma Resusc Emerg Med Date: 2016-03-08 Impact factor: 2.953