Validation of the Conventional Trauma and Injury Severity Score and a Newly Developed Survival Predictive Model in Pediatric Patients with Blunt Trauma: A Nationwide Observation Study
To date, there is no clinically useful prediction model that is suitable for Japanese pediatric trauma patients. Herein, this study aimed to developed a model for predicting the survival of Japanese pediatric patients with blunt trauma and compare its validity with that of the conventional TRISS mod...
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| Format: | Article |
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MDPI AG
2023-09-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/9/1542 |
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| author | Chiaki Toida Takashi Muguruma Masayasu Gakumazawa Mafumi Shinohara Takeru Abe Ichiro Takeuchi |
| author_facet | Chiaki Toida Takashi Muguruma Masayasu Gakumazawa Mafumi Shinohara Takeru Abe Ichiro Takeuchi |
| author_sort | Chiaki Toida |
| collection | DOAJ |
| description | To date, there is no clinically useful prediction model that is suitable for Japanese pediatric trauma patients. Herein, this study aimed to developed a model for predicting the survival of Japanese pediatric patients with blunt trauma and compare its validity with that of the conventional TRISS model. Patients registered in the Japan Trauma Data Bank were grouped into a derivation cohort (2009–2013) and validation cohort (2014–2018). Logistic regression analysis was performed using the derivation dataset to establish prediction models using age, injury severity, and physiology. The validity of the modified model was evaluated by the area under the receiver operating characteristic curve (AUC). Among 11 predictor models, Model 1 and Model 11 had the best performance (AUC = 0.980). The AUC of all models was lower in patients with survival probability Ps < 0.5 than in patients with Ps ≥ 0.5. The AUC of all models was lower in neonates/infants than in other age categories. Model 11 also had the best performance (AUC = 0.762 and 0.909, respectively) in patients with Ps < 0.5 and neonates/infants. The predictive ability of the newly modified models was not superior to that of the current TRISS model. Our results may be useful to develop a highly accurate prediction model based on the new predictive variables and cutoff values associated with the survival mortality of injured Japanese pediatric patients who are younger and more severely injured by using a nationwide dataset with fewer missing data and added valuables, which can be used to evaluate the age-related physiological and anatomical severity of injured patients. |
| first_indexed | 2024-03-10T22:55:10Z |
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| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T22:55:10Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-4e7829b2e7164f1bbf9b3fd4bf0b23dd2023-11-19T10:03:58ZengMDPI AGChildren2227-90672023-09-01109154210.3390/children10091542Validation of the Conventional Trauma and Injury Severity Score and a Newly Developed Survival Predictive Model in Pediatric Patients with Blunt Trauma: A Nationwide Observation StudyChiaki Toida0Takashi Muguruma1Masayasu Gakumazawa2Mafumi Shinohara3Takeru Abe4Ichiro Takeuchi5Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo 173-8606, JapanDepartment of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, JapanDepartment of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, JapanDepartment of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, JapanDepartment of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, JapanDepartment of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, JapanTo date, there is no clinically useful prediction model that is suitable for Japanese pediatric trauma patients. Herein, this study aimed to developed a model for predicting the survival of Japanese pediatric patients with blunt trauma and compare its validity with that of the conventional TRISS model. Patients registered in the Japan Trauma Data Bank were grouped into a derivation cohort (2009–2013) and validation cohort (2014–2018). Logistic regression analysis was performed using the derivation dataset to establish prediction models using age, injury severity, and physiology. The validity of the modified model was evaluated by the area under the receiver operating characteristic curve (AUC). Among 11 predictor models, Model 1 and Model 11 had the best performance (AUC = 0.980). The AUC of all models was lower in patients with survival probability Ps < 0.5 than in patients with Ps ≥ 0.5. The AUC of all models was lower in neonates/infants than in other age categories. Model 11 also had the best performance (AUC = 0.762 and 0.909, respectively) in patients with Ps < 0.5 and neonates/infants. The predictive ability of the newly modified models was not superior to that of the current TRISS model. Our results may be useful to develop a highly accurate prediction model based on the new predictive variables and cutoff values associated with the survival mortality of injured Japanese pediatric patients who are younger and more severely injured by using a nationwide dataset with fewer missing data and added valuables, which can be used to evaluate the age-related physiological and anatomical severity of injured patients.https://www.mdpi.com/2227-9067/10/9/1542trauma scoring systemTrauma and Injury Severity Scoresurvival prediction modelchildrenpediatric patients with blunt traumaJapan Trauma Data Bank |
| spellingShingle | Chiaki Toida Takashi Muguruma Masayasu Gakumazawa Mafumi Shinohara Takeru Abe Ichiro Takeuchi Validation of the Conventional Trauma and Injury Severity Score and a Newly Developed Survival Predictive Model in Pediatric Patients with Blunt Trauma: A Nationwide Observation Study Children trauma scoring system Trauma and Injury Severity Score survival prediction model children pediatric patients with blunt trauma Japan Trauma Data Bank |
| title | Validation of the Conventional Trauma and Injury Severity Score and a Newly Developed Survival Predictive Model in Pediatric Patients with Blunt Trauma: A Nationwide Observation Study |
| title_full | Validation of the Conventional Trauma and Injury Severity Score and a Newly Developed Survival Predictive Model in Pediatric Patients with Blunt Trauma: A Nationwide Observation Study |
| title_fullStr | Validation of the Conventional Trauma and Injury Severity Score and a Newly Developed Survival Predictive Model in Pediatric Patients with Blunt Trauma: A Nationwide Observation Study |
| title_full_unstemmed | Validation of the Conventional Trauma and Injury Severity Score and a Newly Developed Survival Predictive Model in Pediatric Patients with Blunt Trauma: A Nationwide Observation Study |
| title_short | Validation of the Conventional Trauma and Injury Severity Score and a Newly Developed Survival Predictive Model in Pediatric Patients with Blunt Trauma: A Nationwide Observation Study |
| title_sort | validation of the conventional trauma and injury severity score and a newly developed survival predictive model in pediatric patients with blunt trauma a nationwide observation study |
| topic | trauma scoring system Trauma and Injury Severity Score survival prediction model children pediatric patients with blunt trauma Japan Trauma Data Bank |
| url | https://www.mdpi.com/2227-9067/10/9/1542 |
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