J A Llompart-Pou1, M Chico-Fernández2, M Sánchez-Casado3, R Salaberria-Udabe4, C Carbayo-Górriz5, F Guerrero-López6, J González-Robledo7, M Á Ballesteros-Sanz8, R Herrán-Monge9, L Servià-Goixart10, R León-López11, E Val-Jordán12. 1. Servei de Medicina Intensiva, Hospital Universitari Son Espases, Carretera Valldemossa, 79, 07010, Palma de Mallorca, Spain. juanantonio.llompart@ssib.es. 2. UCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain. 3. Servicio de Medicina Intensiva, Hospital Virgen de la Salud, Toledo, Spain. 4. Servicio de Medicina Intensiva, Hospital Universitario de Donostia, San Sebastián, Spain. 5. Servicio de Medicina Intensiva, Complejo Hospitalario de Torrecárdenas, Almería, Spain. 6. Servicio de Medicina Intensiva, Hospital Universitario Virgen de las Nieves, Granada, Spain. 7. Servicio de Medicina Intensiva, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain. 8. Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 9. Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Valladolid, Spain. 10. Servicio de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Lleida, Spain. 11. Servicio de Medicina Intensiva, Ciudad Sanitaria Reina Sofia, Córdoba, Spain. 12. Servicio de Medicina Intensiva, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Abstract
PURPOSE: We evaluated the predictive ability of mechanism, Glasgow coma scale, age and arterial pressure (MGAP), Glasgow coma scale, age and systolic blood pressure (GAP), and triage-revised trauma Score (T-RTS) scores in patients from the Spanish trauma ICU registry using the trauma and injury severity score (TRISS) as a reference standard. METHODS: Patients admitted for traumatic disease in the participating ICU were included. Quantitative data were reported as median [interquartile range (IQR), categorical data as number (percentage)]. Comparisons between groups with quantitative variables and categorical variables were performed using Student's T Test and Chi Square Test, respectively. We performed receiving operating curves (ROC) and evaluated the area under the curve (AUC) with its 95 % confidence interval (CI). Sensitivity, specificity, positive predictive and negative predictive values and accuracy were evaluated in all the scores. A value of p < 0.05 was considered significant. RESULTS: The final sample included 1361 trauma ICU patients. Median age was 45 (30-61) years. 1092 patients (80.3 %) were male. Median ISS was 18 (13-26) and median T-RTS was 11 (10-12). Median GAP was 20 (15-22) and median MGAP 24 (20-27). Observed mortality was 17.7 % whilst predicted mortality using TRISS was 16.9 %. The AUC in the scores evaluated was: TRISS 0.897 (95 % CI 0.876-0.918), MGAP 0.860 (95 % CI 0.835-0.886), GAP 0.849 (95 % CI 0.823-0.876) and T-RTS 0.796 (95 % CI 0.762-0.830). CONCLUSIONS: Both MGAP and GAP scores performed better than the T-RTS in the prediction of hospital mortality in Spanish trauma ICU patients. Since these are easy-to-perform scores, they should be incorporated in clinical practice as a triaging tool.
PURPOSE: We evaluated the predictive ability of mechanism, Glasgow coma scale, age and arterial pressure (MGAP), Glasgow coma scale, age and systolic blood pressure (GAP), and triage-revised trauma Score (T-RTS) scores in patients from the Spanish trauma ICU registry using the trauma and injury severity score (TRISS) as a reference standard. METHODS:Patients admitted for traumatic disease in the participating ICU were included. Quantitative data were reported as median [interquartile range (IQR), categorical data as number (percentage)]. Comparisons between groups with quantitative variables and categorical variables were performed using Student's T Test and Chi Square Test, respectively. We performed receiving operating curves (ROC) and evaluated the area under the curve (AUC) with its 95 % confidence interval (CI). Sensitivity, specificity, positive predictive and negative predictive values and accuracy were evaluated in all the scores. A value of p < 0.05 was considered significant. RESULTS: The final sample included 1361 trauma ICUpatients. Median age was 45 (30-61) years. 1092 patients (80.3 %) were male. Median ISS was 18 (13-26) and median T-RTS was 11 (10-12). Median GAP was 20 (15-22) and median MGAP 24 (20-27). Observed mortality was 17.7 % whilst predicted mortality using TRISS was 16.9 %. The AUC in the scores evaluated was: TRISS 0.897 (95 % CI 0.876-0.918), MGAP 0.860 (95 % CI 0.835-0.886), GAP 0.849 (95 % CI 0.823-0.876) and T-RTS 0.796 (95 % CI 0.762-0.830). CONCLUSIONS: Both MGAP and GAP scores performed better than the T-RTS in the prediction of hospital mortality in Spanish trauma ICUpatients. Since these are easy-to-perform scores, they should be incorporated in clinical practice as a triaging tool.
Authors: Juanita A Haagsma; Nicholas Graetz; Ian Bolliger; Mohsen Naghavi; Hideki Higashi; Erin C Mullany; Semaw Ferede Abera; Jerry Puthenpurakal Abraham; Koranteng Adofo; Ubai Alsharif; Emmanuel A Ameh; Walid Ammar; Carl Abelardo T Antonio; Lope H Barrero; Tolesa Bekele; Dipan Bose; Alexandra Brazinova; Ferrán Catalá-López; Lalit Dandona; Rakhi Dandona; Paul I Dargan; Diego De Leo; Louisa Degenhardt; Sarah Derrett; Samath D Dharmaratne; Tim R Driscoll; Leilei Duan; Sergey Petrovich Ermakov; Farshad Farzadfar; Valery L Feigin; Richard C Franklin; Belinda Gabbe; Richard A Gosselin; Nima Hafezi-Nejad; Randah Ribhi Hamadeh; Martha Hijar; Guoqing Hu; Sudha P Jayaraman; Guohong Jiang; Yousef Saleh Khader; Ejaz Ahmad Khan; Sanjay Krishnaswami; Chanda Kulkarni; Fiona E Lecky; Ricky Leung; Raimundas Lunevicius; Ronan Anthony Lyons; Marek Majdan; Amanda J Mason-Jones; Richard Matzopoulos; Peter A Meaney; Wubegzier Mekonnen; Ted R Miller; Charles N Mock; Rosana E Norman; Ricardo Orozco; Suzanne Polinder; Farshad Pourmalek; Vafa Rahimi-Movaghar; Amany Refaat; David Rojas-Rueda; Nobhojit Roy; David C Schwebel; Amira Shaheen; Saeid Shahraz; Vegard Skirbekk; Kjetil Søreide; Sergey Soshnikov; Dan J Stein; Bryan L Sykes; Karen M Tabb; Awoke Misganaw Temesgen; Eric Yeboah Tenkorang; Alice M Theadom; Bach Xuan Tran; Tommi J Vasankari; Monica S Vavilala; Vasiliy Victorovich Vlassov; Solomon Meseret Woldeyohannes; Paul Yip; Naohiro Yonemoto; Mustafa Z Younis; Chuanhua Yu; Christopher J L Murray; Theo Vos Journal: Inj Prev Date: 2015-12-03 Impact factor: 2.399