Janis Lapsley1, Galina M Hayes1, Julia P Sumner1.
Abstract
OBJECTIVES: To examine the Animal Trauma Triage (ATT) and modified Glasgow Coma Scale (mGCS) scores as predictors of mortality in injured cats.
DESIGN: Observational cohort study conducted September 2013 to March 2015.
SETTING: Nine Level I and II veterinary trauma centers. ANIMALS: Consecutive sample of 711 cats reported on the Veterinary Committee on Trauma (VetCOT) case registry.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: We compared the predictive power (area under receiver operating characteristic curve; AUROC) and calibration of the ATT and mGCS scores to their components. Overall mortality risk was 16.5% (95% confidence interval [CI], 13.9-19.4). Head trauma prevalence was 11.8% (n = 84). The ATT score showed a linear relationship with mortality risk. Discriminatory performance of the ATT score was excellent (AUROC = 0.87 [95% CI, 0.84-0.90]). Each ATT score increase of 1 point was associated with an increase in mortality odds of 1.78 (95% CI, 1.61-1.97, P < 0.001). The eye/muscle/integument category of the ATT showed the lowest discrimination (AUROC = 0.60). When this component, skeletal, and cardiac components were omitted from score calculation, there was no loss in discriminatory capacity compared with the full score (AUROC = 0.86 vs 0.87, respectively, P = 0.66). The mGCS showed fair performance overall for prediction of mortality, but the point estimate of performance improved when restricted to head trauma patients (AUROC = 0.75, 95% CI, 0.70-0.80 vs AUROC = 0.80, 95% CI, 0.70-0.90). The motor component of the mGCS showed the best predictive performance (AUROC = 0.71); however, the full score performed better than the motor component alone (P = 0.004). When assessment was restricted to patients with head injury (n = 84), there was no difference in performance between the ATT and mGCS scores (AUROC = 0.82 vs 0.80, P = 0.67).
CONCLUSION: On a large, multicenter dataset of feline trauma patients, the ATT score showed excellent discrimination and calibration for predicting mortality; however, an abbreviated score calculated from the perfusion, respiratory, and neurologic categories showed equivalent performance. © Veterinary Emergency and Critical Care Society 2019.
OBJECTIVES: To examine the Animal Trauma Triage (ATT) and modified Glasgow Coma Scale (mGCS) scores as predictors of mortality in injured cats.
DESIGN: Observational cohort study conducted September 2013 to March 2015.
SETTING: Nine Level I and II veterinary trauma centers. ANIMALS: Consecutive sample of 711 cats reported on the Veterinary Committee on Trauma (VetCOT) case registry.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: We compared the predictive power (area under receiver operating characteristic curve; AUROC) and calibration of the ATT and mGCS scores to their components. Overall mortality risk was 16.5% (95% confidence interval [CI], 13.9-19.4). Head trauma prevalence was 11.8% (n = 84). The ATT score showed a linear relationship with mortality risk. Discriminatory performance of the ATT score was excellent (AUROC = 0.87 [95% CI, 0.84-0.90]). Each ATT score increase of 1 point was associated with an increase in mortality odds of 1.78 (95% CI, 1.61-1.97, P < 0.001). The eye/muscle/integument category of the ATT showed the lowest discrimination (AUROC = 0.60). When this component, skeletal, and cardiac components were omitted from score calculation, there was no loss in discriminatory capacity compared with the full score (AUROC = 0.86 vs 0.87, respectively, P = 0.66). The mGCS showed fair performance overall for prediction of mortality, but the point estimate of performance improved when restricted to head trauma patients (AUROC = 0.75, 95% CI, 0.70-0.80 vs AUROC = 0.80, 95% CI, 0.70-0.90). The motor component of the mGCS showed the best predictive performance (AUROC = 0.71); however, the full score performed better than the motor component alone (P = 0.004). When assessment was restricted to patients with head injury (n = 84), there was no difference in performance between the ATT and mGCS scores (AUROC = 0.82 vs 0.80, P = 0.67).
CONCLUSION: On a large, multicenter dataset of feline trauma patients, the ATT score showed excellent discrimination and calibration for predicting mortality; however, an abbreviated score calculated from the perfusion, respiratory, and neurologic categories showed equivalent performance. © Veterinary Emergency and Critical Care Society 2019.
Entities:
Keywords:
feline; illness severity score; mortality predictor
Year: 2019
PMID： 31468694 PMCID： PMC6739155 DOI： 10.1111/vec.12885
Source DB: PubMed Journal: J Vet Emerg Crit Care (San Antonio) ISSN： 1476-4431