Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE
Abstract Background Severity scores are commonly used for outcome adjustment and benchmarking of trauma care provided. No specific models performed only with critically ill patients are available. Our objective was to develop a new score for early mortality prediction in trauma ICU patients. Methods...
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| Format: | Article |
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BMC
2021-12-01
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| Series: | Critical Care |
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| Online Access: | https://doi.org/10.1186/s13054-021-03845-6 |
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| author | Luis Serviá Juan Antonio Llompart-Pou Mario Chico-Fernández Neus Montserrat Mariona Badia Jesús Abelardo Barea-Mendoza María Ángeles Ballesteros-Sanz Javier Trujillano the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC) |
| author_facet | Luis Serviá Juan Antonio Llompart-Pou Mario Chico-Fernández Neus Montserrat Mariona Badia Jesús Abelardo Barea-Mendoza María Ángeles Ballesteros-Sanz Javier Trujillano the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC) |
| author_sort | Luis Serviá |
| collection | DOAJ |
| description | Abstract Background Severity scores are commonly used for outcome adjustment and benchmarking of trauma care provided. No specific models performed only with critically ill patients are available. Our objective was to develop a new score for early mortality prediction in trauma ICU patients. Methods This is a retrospective study using the Spanish Trauma ICU registry (RETRAUCI) 2015–2019. Patients were divided and analysed into the derivation (2015–2017) and validation sets (2018–2019). We used as candidate variables to be associated with mortality those available in RETRAUCI that could be collected in the first 24 h after ICU admission. Using logistic regression methodology, a simple score (RETRASCORE) was created with points assigned to each selected variable. The performance of the model was carried out according to global measures, discrimination and calibration. Results The analysis included 9465 patients: derivation set 5976 and validation set 3489. Thirty-day mortality was 12.2%. The predicted probability of 30-day mortality was determined by the following equation: 1/(1 + exp (− y)), where y = 0.598 (Age 50–65) + 1.239 (Age 66–75) + 2.198 (Age > 75) + 0.349 (PRECOAG) + 0.336 (Pre-hospital intubation) + 0.662 (High-risk mechanism) + 0.950 (unilateral mydriasis) + 3.217 (bilateral mydriasis) + 0.841 (Glasgow ≤ 8) + 0.495 (MAIS-Head) − 0.271 (MAIS-Thorax) + 1.148 (Haemodynamic failure) + 0.708 (Respiratory failure) + 0.567 (Coagulopathy) + 0.580 (Mechanical ventilation) + 0.452 (Massive haemorrhage) − 5.432. The AUROC was 0.913 (0.903–0.923) in the derivation set and 0.929 (0.918–0.940) in the validation set. Conclusions The newly developed RETRASCORE is an early, easy-to-calculate and specific score to predict in-hospital mortality in trauma ICU patients. Although it has achieved adequate internal validation, it must be externally validated. |
| first_indexed | 2024-12-13T16:43:33Z |
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| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-12-13T16:43:33Z |
| publishDate | 2021-12-01 |
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| series | Critical Care |
| spelling | doaj.art-b8024683f7424ad9968cc5d31c0647b72022-12-21T23:38:14ZengBMCCritical Care1364-85352021-12-0125111010.1186/s13054-021-03845-6Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORELuis Serviá0Juan Antonio Llompart-Pou1Mario Chico-Fernández2Neus Montserrat3Mariona Badia4Jesús Abelardo Barea-Mendoza5María Ángeles Ballesteros-Sanz6Javier Trujillano7the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)Servei de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleidaServei de Medicina Intensiva, Hospital Universitari Son Espases, Institut d’Investigació Sanitària Illes Balears (IdISBa)UCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de OctubreServei de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleidaServei de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleidaUCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de OctubreServicio de Medicina Intensiva, Hospital Universitario Marqués de ValdecillaServei de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleidaAbstract Background Severity scores are commonly used for outcome adjustment and benchmarking of trauma care provided. No specific models performed only with critically ill patients are available. Our objective was to develop a new score for early mortality prediction in trauma ICU patients. Methods This is a retrospective study using the Spanish Trauma ICU registry (RETRAUCI) 2015–2019. Patients were divided and analysed into the derivation (2015–2017) and validation sets (2018–2019). We used as candidate variables to be associated with mortality those available in RETRAUCI that could be collected in the first 24 h after ICU admission. Using logistic regression methodology, a simple score (RETRASCORE) was created with points assigned to each selected variable. The performance of the model was carried out according to global measures, discrimination and calibration. Results The analysis included 9465 patients: derivation set 5976 and validation set 3489. Thirty-day mortality was 12.2%. The predicted probability of 30-day mortality was determined by the following equation: 1/(1 + exp (− y)), where y = 0.598 (Age 50–65) + 1.239 (Age 66–75) + 2.198 (Age > 75) + 0.349 (PRECOAG) + 0.336 (Pre-hospital intubation) + 0.662 (High-risk mechanism) + 0.950 (unilateral mydriasis) + 3.217 (bilateral mydriasis) + 0.841 (Glasgow ≤ 8) + 0.495 (MAIS-Head) − 0.271 (MAIS-Thorax) + 1.148 (Haemodynamic failure) + 0.708 (Respiratory failure) + 0.567 (Coagulopathy) + 0.580 (Mechanical ventilation) + 0.452 (Massive haemorrhage) − 5.432. The AUROC was 0.913 (0.903–0.923) in the derivation set and 0.929 (0.918–0.940) in the validation set. Conclusions The newly developed RETRASCORE is an early, easy-to-calculate and specific score to predict in-hospital mortality in trauma ICU patients. Although it has achieved adequate internal validation, it must be externally validated.https://doi.org/10.1186/s13054-021-03845-6Trauma and injury severity scoreIntensive care unitMortalityPrognostic scoring systems |
| spellingShingle | Luis Serviá Juan Antonio Llompart-Pou Mario Chico-Fernández Neus Montserrat Mariona Badia Jesús Abelardo Barea-Mendoza María Ángeles Ballesteros-Sanz Javier Trujillano the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC) Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE Critical Care Trauma and injury severity score Intensive care unit Mortality Prognostic scoring systems |
| title | Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE |
| title_full | Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE |
| title_fullStr | Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE |
| title_full_unstemmed | Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE |
| title_short | Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE |
| title_sort | development of a new score for early mortality prediction in trauma icu patients retrascore |
| topic | Trauma and injury severity score Intensive care unit Mortality Prognostic scoring systems |
| url | https://doi.org/10.1186/s13054-021-03845-6 |
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