Developing a Simple Clinical Score for Predicting Mortality and Need for ICU in Trauma Patients

Author:

Haider Ansab1,Con Jorge1,Prabhakaran Kartik1,Anderson Patrice1,Policastro Anthony1,Feeney James1,Latifi Rifat1

Affiliation:

1. Division of Trauma, Critical Care, and Emergency Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York

Abstract

Several models exist to predict trauma center need in the prehospital setting; however, there is lack of simple clinical tools to predict the need for ICU admission and mortality in trauma patients. The aim of our study was to develop a simple clinical tool that can be used with ease in the prehospital or emergency setting and can reliably predict the need for ICU admission and mortality in trauma patients. We abstracted one year of National Trauma Data Bank for all patients aged ≥ 18 years. Transferred patients and those dead on arrival were excluded. Patient demographics, injury parameters, vital signs, and Glasgow Coma Scale (GCS) were recorded. Our primary outcome measures were mortality and ICU admission. Logistic regression analysis was performed using three variables (age > 55 years, shock index (SI) > 1, and GCS score) to determine the appropriate weights for predicting mortality. Appropriate weights derived from regression analysis were used to construct a simple SI, age, and GCS (SAG) score, and associated mortality and ICU admissions were calculated for three different risk groups (low, intermediate, and high). A total of 281,522 patients were included. The mean age was 47 ± 20 years, and 65 per cent were male. The overall mortality rate was 2.9 per cent, and the rate of ICU admission was 28.7 per cent. The SAG score was constructed using weights derived from regression analysis for age ≤ 55 years (4 points), SI< 1 (3 points), and GCS (3-15 points). The median [IQR] SAG score was 21 [18–22]. The area under the receiver operating curve [95% Confidence Interval (CI)] of the SAG score for predicting mortality and ICU admission was 0.873 [0.870–0.877] and 0.644 [0.642–0.647], respectively. Each 1-point increase in the SAG score was associated with 18 per cent lower odds of mortality (odds ratio [95% CI]: 0.822 [0.820–0.825]) and 10 per cent lower odds of ICU admission (odds ratio [95% CI]: 0.901 [0.899–0.902]). The SAG score is a simple clinical tool derived from variables that can be assessed with ease during the initial evaluation of trauma patients. It provides a rapid assessment and can reliably predict mortality and need for ICU admission in trauma patients. This simple tool may allow early resource mobilization possibly even before the arrival of the patient.

Publisher

SAGE Publications

Subject

General Medicine

Cited by 4 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3