Validation of the trauma mortality prediction scores from a Malaysian population
Abstract Background Well-known trauma mortality prediction scores such as New Injury Severity Score (NISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) have been externally validated from high-income countries with established trauma databases. However, these scores were...
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| Format: | Article |
| Language: | English |
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Oxford University Press
2017-12-01
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| Series: | Burns & Trauma |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41038-017-0102-z |
| _version_ | 1817976809303572480 |
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| author | Jih Huei Tan Henry Chor Lip Tan Nur Azlin Md Noh Yuzaidi Mohamad Rizal Imran Alwi |
| author_facet | Jih Huei Tan Henry Chor Lip Tan Nur Azlin Md Noh Yuzaidi Mohamad Rizal Imran Alwi |
| author_sort | Jih Huei Tan |
| collection | DOAJ |
| description | Abstract Background Well-known trauma mortality prediction scores such as New Injury Severity Score (NISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) have been externally validated from high-income countries with established trauma databases. However, these scores were never used in Malaysian population. In this current study, we attempted to validate these scoring systems using our regional trauma surgery database. Methods A retrospective analysis of the regional Malaysian Trauma Surgery Database was performed over a period of 3 years from May 2011 to April 2014. NISS, RTS, Major Trauma Outcome Study (MTOS)-TRISS, and National Trauma Database (NTrD)-TRISS scores were recorded and calculated. Individual scoring system’s performance in predicting trauma mortality was compared by calculating the area under the receiver operating characteristic (AUC) curve. Youden index and associated optimal cutoff values for each scoring system was calculated to predict mortality. The corresponding positive predictive value, negative predictive value, and accuracy of the cutoff values were calculated. Results A total of 2208 trauma patients (2004 blunt and 204 penetrating injuries) with mean age of 36 (SD = 16) years were included. There were 239 deaths with a corresponding mortality rate of 10.8%. The AUC calculated for the NISS, RTS, MTOS-TRISS, and NTrD-TRISS were 0.878, 0.802, 0.812, and 0.848, respectively. The NISS score with a cutoff value of 24, sensitivity of 86.6% and specificity of 74.3%, outperformed the rest (p < 0.001). Mortality was predicted by NISS with an overall accuracy of 75.6%; its positive predictive value was at 29.02% and negative predictive value at 97.86%. Conclusion Amongst the four scores, the NISS score is the best trauma mortality prediction model suited for a local Malaysian trauma population. Further validation with multicentre data in the country may require to ascertain the finding. |
| first_indexed | 2024-04-13T22:08:33Z |
| format | Article |
| id | doaj.art-ed3bb87efcd14425a2aec97b3534c356 |
| institution | Directory Open Access Journal |
| issn | 2321-3876 |
| language | English |
| last_indexed | 2024-04-13T22:08:33Z |
| publishDate | 2017-12-01 |
| publisher | Oxford University Press |
| record_format | Article |
| series | Burns & Trauma |
| spelling | doaj.art-ed3bb87efcd14425a2aec97b3534c3562022-12-22T02:27:51ZengOxford University PressBurns & Trauma2321-38762017-12-01511610.1186/s41038-017-0102-zValidation of the trauma mortality prediction scores from a Malaysian populationJih Huei Tan0Henry Chor Lip Tan1Nur Azlin Md Noh2Yuzaidi Mohamad3Rizal Imran Alwi4General Surgery Department, Hospital Sultanah AminahGeneral Surgery Department, Hospital Sultanah AminahGeneral Surgery Department, Hospital Sultanah AminahGeneral Surgery Department, Hospital Sultanah AminahGeneral Surgery Department, Hospital Sultanah AminahAbstract Background Well-known trauma mortality prediction scores such as New Injury Severity Score (NISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) have been externally validated from high-income countries with established trauma databases. However, these scores were never used in Malaysian population. In this current study, we attempted to validate these scoring systems using our regional trauma surgery database. Methods A retrospective analysis of the regional Malaysian Trauma Surgery Database was performed over a period of 3 years from May 2011 to April 2014. NISS, RTS, Major Trauma Outcome Study (MTOS)-TRISS, and National Trauma Database (NTrD)-TRISS scores were recorded and calculated. Individual scoring system’s performance in predicting trauma mortality was compared by calculating the area under the receiver operating characteristic (AUC) curve. Youden index and associated optimal cutoff values for each scoring system was calculated to predict mortality. The corresponding positive predictive value, negative predictive value, and accuracy of the cutoff values were calculated. Results A total of 2208 trauma patients (2004 blunt and 204 penetrating injuries) with mean age of 36 (SD = 16) years were included. There were 239 deaths with a corresponding mortality rate of 10.8%. The AUC calculated for the NISS, RTS, MTOS-TRISS, and NTrD-TRISS were 0.878, 0.802, 0.812, and 0.848, respectively. The NISS score with a cutoff value of 24, sensitivity of 86.6% and specificity of 74.3%, outperformed the rest (p < 0.001). Mortality was predicted by NISS with an overall accuracy of 75.6%; its positive predictive value was at 29.02% and negative predictive value at 97.86%. Conclusion Amongst the four scores, the NISS score is the best trauma mortality prediction model suited for a local Malaysian trauma population. Further validation with multicentre data in the country may require to ascertain the finding.http://link.springer.com/article/10.1186/s41038-017-0102-zTrauma scoring systemPrediction modelInjury gradingSoutheast AsiaNew Injury Severity ScoreRevised Trauma Score |
| spellingShingle | Jih Huei Tan Henry Chor Lip Tan Nur Azlin Md Noh Yuzaidi Mohamad Rizal Imran Alwi Validation of the trauma mortality prediction scores from a Malaysian population Burns & Trauma Trauma scoring system Prediction model Injury grading Southeast Asia New Injury Severity Score Revised Trauma Score |
| title | Validation of the trauma mortality prediction scores from a Malaysian population |
| title_full | Validation of the trauma mortality prediction scores from a Malaysian population |
| title_fullStr | Validation of the trauma mortality prediction scores from a Malaysian population |
| title_full_unstemmed | Validation of the trauma mortality prediction scores from a Malaysian population |
| title_short | Validation of the trauma mortality prediction scores from a Malaysian population |
| title_sort | validation of the trauma mortality prediction scores from a malaysian population |
| topic | Trauma scoring system Prediction model Injury grading Southeast Asia New Injury Severity Score Revised Trauma Score |
| url | http://link.springer.com/article/10.1186/s41038-017-0102-z |
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