Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort study
Abstract Background Little is known about the performance of severity indices for indicating intensive care and predicting mortality in the Intensive Care Unit (ICU) of trauma patients. This study aimed to compare the performance of severity indices to predict trauma patients’ ICU admission and mort...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-023-01532-6 |
| _version_ | 1797398092806356992 |
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| author | Tatiane Gonçalves Gomes de Novais do Rio Lilia de Souza Nogueira Fernanda Rodrigues Lima Carolina Cassiano Diogo de Freitas Valeiro Garcia |
| author_facet | Tatiane Gonçalves Gomes de Novais do Rio Lilia de Souza Nogueira Fernanda Rodrigues Lima Carolina Cassiano Diogo de Freitas Valeiro Garcia |
| author_sort | Tatiane Gonçalves Gomes de Novais do Rio |
| collection | DOAJ |
| description | Abstract Background Little is known about the performance of severity indices for indicating intensive care and predicting mortality in the Intensive Care Unit (ICU) of trauma patients. This study aimed to compare the performance of severity indices to predict trauma patients’ ICU admission and mortality. Methods A retrospective cohort study which analyzed the electronic medical records of trauma patients aged ≥ 18 years, treated at a hospital in Brazil, between 2014 and 2017. Physiological [Revised Trauma Score (RTS), New Trauma Score (NTS) and modified Rapid Emergency Medicine Score (mREMS)], anatomical [Injury Severity Score (ISS) and New Injury Severity Score (NISS)] and mixed indices [Trauma and Injury Severity Score (TRISS), New Trauma and Injury Severity Score (NTRISS), Base-deficit Injury Severity Score (BISS) and Base-deficit and New Injury Severity Score (BNISS)] were compared in analyzing the outcomes (ICU admission and mortality) using the Area Under the Receiver Operating Characteristics Curves (AUC–ROC). Results From the 747 trauma patients analyzed (52.5% female; mean age 51.5 years; 36.1% falls), 106 (14.2%) were admitted to the ICU and 6 (0.8%) died in the unit. The ISS (AUC 0.919) and NISS (AUC 0.916) had better predictive capacity for ICU admission of trauma patients. The NISS (AUC 0.949), TRISS (AUC 0.909), NTRISS (AUC 0.967), BISS (AUC 0.902) and BNISS (AUC 0.976) showed excellent performance in predicting ICU mortality. Conclusions Anatomical indices showed excellent predictive ability for admission of trauma patients to the ICU. The NISS and the mixed indices had the best performances regarding mortality in the ICU. |
| first_indexed | 2024-03-09T01:20:43Z |
| format | Article |
| id | doaj.art-abf4432796a24e3ca0a59c6b5e8c3023 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-09T01:20:43Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-abf4432796a24e3ca0a59c6b5e8c30232023-12-10T12:12:17ZengBMCEuropean Journal of Medical Research2047-783X2023-12-012811710.1186/s40001-023-01532-6Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort studyTatiane Gonçalves Gomes de Novais do Rio0Lilia de Souza Nogueira1Fernanda Rodrigues Lima2Carolina Cassiano3Diogo de Freitas Valeiro Garcia4Nursing Department, Samaritano Higienópolis HospitalMedical-Surgical Nursing Department, School of Nursing, University of São Paulo School of Nursing, University of São PauloNursing Department, Faculdade de Ciências Médicas da Santa Casa de São PauloNove de Julho UniversityAbstract Background Little is known about the performance of severity indices for indicating intensive care and predicting mortality in the Intensive Care Unit (ICU) of trauma patients. This study aimed to compare the performance of severity indices to predict trauma patients’ ICU admission and mortality. Methods A retrospective cohort study which analyzed the electronic medical records of trauma patients aged ≥ 18 years, treated at a hospital in Brazil, between 2014 and 2017. Physiological [Revised Trauma Score (RTS), New Trauma Score (NTS) and modified Rapid Emergency Medicine Score (mREMS)], anatomical [Injury Severity Score (ISS) and New Injury Severity Score (NISS)] and mixed indices [Trauma and Injury Severity Score (TRISS), New Trauma and Injury Severity Score (NTRISS), Base-deficit Injury Severity Score (BISS) and Base-deficit and New Injury Severity Score (BNISS)] were compared in analyzing the outcomes (ICU admission and mortality) using the Area Under the Receiver Operating Characteristics Curves (AUC–ROC). Results From the 747 trauma patients analyzed (52.5% female; mean age 51.5 years; 36.1% falls), 106 (14.2%) were admitted to the ICU and 6 (0.8%) died in the unit. The ISS (AUC 0.919) and NISS (AUC 0.916) had better predictive capacity for ICU admission of trauma patients. The NISS (AUC 0.949), TRISS (AUC 0.909), NTRISS (AUC 0.967), BISS (AUC 0.902) and BNISS (AUC 0.976) showed excellent performance in predicting ICU mortality. Conclusions Anatomical indices showed excellent predictive ability for admission of trauma patients to the ICU. The NISS and the mixed indices had the best performances regarding mortality in the ICU.https://doi.org/10.1186/s40001-023-01532-6TraumaTrauma severity indicesIntensive care unitsMortalityROC Curve |
| spellingShingle | Tatiane Gonçalves Gomes de Novais do Rio Lilia de Souza Nogueira Fernanda Rodrigues Lima Carolina Cassiano Diogo de Freitas Valeiro Garcia Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort study European Journal of Medical Research Trauma Trauma severity indices Intensive care units Mortality ROC Curve |
| title | Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort study |
| title_full | Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort study |
| title_fullStr | Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort study |
| title_full_unstemmed | Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort study |
| title_short | Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort study |
| title_sort | performance of severity indices for admission and mortality of trauma patients in the intensive care unit a retrospective cohort study |
| topic | Trauma Trauma severity indices Intensive care units Mortality ROC Curve |
| url | https://doi.org/10.1186/s40001-023-01532-6 |
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