scholarly journals Predicting Mortality of Korean Geriatric Trauma Patients: A Comparison between Geriatric Trauma Outcome Score and Trauma and Injury Severity Score

2022 ◽  
Vol 63 (1) ◽  
pp. 88
Author(s):  
Jiye Park ◽  
Yunhwan Lee
2020 ◽  
Author(s):  
Libing Jiang ◽  
Zhongjun Zheng ◽  
Mao Zhang

Abstract Purpose: The aim of this study was to describe the age trend of trauma patients and to compare different scoring tools to predict in-hospital mortality in elderly trauma patients.Methods: National Trauma Database (NTDB) in the United States from 2005 to 2015 and the Trauma Register DGU® in German from 1994 to 2012 was searched to describe age change of trauma patients. Then we secondly analyzed the data published in http://datadryad.org/. According to the in-hospital survival status, patients were divided into survival group and non-survival group. Receiver Operating Characteristic Curve (ROC) analysis was used to evaluated the value of ISS (injury severity score); NISS (new injury severity score), APACHE Ⅱ (Acute Physiology and Chronic Health Evaluation Ⅱ), SPAS Ⅱ (simplified acute physiology score Ⅱ) and TRISS (Trauma and Injury Severity Score) in predicting in-hospital mortality among geriatric trauma patients.Results:The analysis of NTDB showed the percentage of geriatric trauma has increased from 0.18 to 0.30, 2005-2015. The analysis of DGU showed the mean age rose from 39.11 in 1993 to 51.10 in 2013, and the percentage of patients aged ≥60 rose from 16.5% to 37.5%. A total of 311 patients aged more than 65 years were secondly analyzed. One hundred and sixty-four (52.73%) patients died in the hospital. ISS, NISS, APACHE, and SAPS in the death group were significantly higher than those in the survival group, but TRISS in the death group was significantly lower than those in the survival group. The AUC of APACHE Ⅱ was 0.715, ISS was 0.807, NISS was 0.850, SPAS Ⅱ was 0.725, and TRISS was 0.828.Conclusion:The increasing number of trauma in the elderly is a challenge for current and future trauma management. Compared with APACHE and SAPS, ISS, NISS and TRISS are more suitable for predicting in-hospital mortality in elderly trauma patients.


2020 ◽  
Author(s):  
Chiaki Toida ◽  
Takashi Muguruma ◽  
Masayasu Gakumazawa ◽  
Mafumi Shinohara ◽  
Takeru Abe ◽  
...  

Abstract Background: In-hospital mortality in trauma patients decreased recently owing to improved trauma injury prevention systems. However, no study which evaluated the validity of Trauma and Injury Severity Score (TRISS) in pediatrics by detailed classification of patients’ age and injury severity in Japan. This retrospective nationwide study evaluated the validity of TRISS in predicting survival in Japanese pediatric patients with blunt trauma by age and injury severity.Methods: Data were obtained from the Japan Trauma Data Bank during 2009−2018.Results: In all age categories, the area under the curve (AUC) for TRISS demonstrated high performance (0.935, 0.981, 0.979, and 0.977). The Accuracy of TRISS was 99.9%, 98.2%, 92.1%, 76.7%, 55.3%, and 72.1% in survival probability (Ps) interval groups (0.96−1.00), (0.91−0.95), (0.76.−0.90), (0.51−0.75), (0.26−0.50), and (0.00−0.25), respectively. The AUC for TRISS demonstrated moderate performance in the Ps interval group (0.96−1.00) and low performance in other Ps interval groups.Conclusions: The TRISS methodology appears to predict survival accurately in Japanese pediatric patients with blunt trauma; however, there were several problems in adopting the TRISS methodology for younger blunt trauma patients with higher injury severity. In the future, we should consider to conducting a simple, high-quality prediction model that is more suitable for pediatric trauma patients than the current TRISS model.


2004 ◽  
Vol 31 (5) ◽  
pp. 299-306 ◽  
Author(s):  
Gustavo Pereira Fraga ◽  
Mario Mantovani ◽  
Luís Alberto Magna

OBJETIVO: O trauma é um problema de saúde pública de enormes proporções. Constitui-se na principal causa de óbitos na população jovem. O Major Trauma Outcome Study (MTOS) é um estudo descritivo e retrospectivo da gravidade das lesões e evolução dos pacientes, considerado como o maior arquivo contemporâneo de informações descritivas de traumatizados. O objetivo do presente estudo é comparar o cálculo retrospectivo do New Injury Severity Score (NISS) com o Injury Severity Score (ISS) já calculado prospectivamente, utilizando o Trauma and Injury Severity Score (TRISS) e uma simples modificação deste índice, denominado de NTRISS (New Trauma and Injury Severity Score), e também comparar esta população submetida à laparotomia com os pacientes do MTOS. MÉTODO: Foram estudados 1.380 pacientes adultos traumatizados e submetidos à laparotomia na Disciplina de Cirurgia do Trauma da Unicamp, em Campinas, durante um período de oito anos. Os dados avaliados foram: demográficos, causa do trauma (fechado ou penetrante, ferimento por projétil de arma de fogo ou arma branca), estado fisiológico na admissão (RTS), diagnóstico anatômico de lesões (ATI, ISS e NISS), probabilidade de sobrevida utilizando o TRISS e o NTRISS, e a evolução do paciente (sobrevivência ou óbito). Foram utilizadas as estatísticas Z e W, inicialmente descritas por Flora, a fim de comparar a predição de óbitos ou sobreviventes com o estudo controle (MTOS). RESULTADOS: A maioria dos pacientes (88,3%) era do sexo masculino e jovem (média de idade de 30,4 anos). O ferimento por projétil de arma de fogo foi o mecanismo de trauma mais freqüente, com 641 casos (46,4%). Quatrocentos e trinta pacientes (31,2%) sofreram trauma fechado. As médias do ATI, ISS e NISS foram, respectivamente, de 12,3, 17,6 e 22,1. A taxa global de mortalidade foi de 16,8% e os pacientes com trauma contuso tiveram a maior mortalidade (29,3%). O NISS identificou melhor os sobreviventes e óbitos se comparado ao ISS, obtendo-se uma maior especificidade com o NTRISS. Foi observado um número significativamente menor de sobreviventes do que o esperado pelo estudo basal, com Z -16,24 com o TRISS e Z -9,40 se aplicado o NTRISS. Variações no valor da estatística W para cada paciente mostraram uma diferença no número de óbitos equivalente a 7,89 mais casos de óbito do que o esperado pelo MTOS, por 100 pacientes tratados, ao se empregar o TRISS, enquanto que estes valores foram reduzidos para 5,14 utilizando-se o NTRISS. CONCLUSÕES: Os métodos utilizados para cálculo da probabilidade de sobrevivência apresentaram limitações, particularmente nesta população com predomínio dos traumas penetrantes. O NISS, com o seu derivado NTRISS, foi o escore que obteve uma melhor predição de sobrevivência se comparado com o ISS. Os resultados obtidos com o TRISS e NTRISS foram estatisticamente piores do que os do MTOS, porém este processo de monitorização destes pacientes traumatizados tem sido importante para assegurar uma condição continuada de controle de qualidade.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chiaki Toida ◽  
Takashi Muguruma ◽  
Masayasu Gakumazawa ◽  
Mafumi Shinohara ◽  
Takeru Abe ◽  
...  

Abstract Background In-hospital mortality in trauma patients has decreased recently owing to improved trauma injury prevention systems. However, no study has evaluated the validity of the Trauma and Injury Severity Score (TRISS) in pediatric patients by a detailed classification of patients’ age and injury severity in Japan. This retrospective nationwide study evaluated the validity of TRISS in predicting survival in Japanese pediatric patients with blunt trauma by age and injury severity. Methods Data were obtained from the Japan Trauma Data Bank during 2009–2018. The outcomes were as follows: (1) patients’ characteristics and mortality by age groups (neonates/infants aged 0 years, preschool children aged 1–5 years, schoolchildren aged 6–11 years, and adolescents aged 12–18 years), (2) validity of survival probability (Ps) assessed using the TRISS methodology by the four age groups and six Ps-interval groups (0.00–0.25, 0.26–0.50, 0.51–0.75, 0.76–0.90, 0.91–0.95, and 0.96–1.00), and (3) the observed/expected survivor ratio by age- and Ps-interval groups. The validity of TRISS was evaluated by the predictive ability of the TRISS method using the receiver operating characteristic (ROC) curves that present the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, area under the receiver operator characteristic curve (AUC) of TRISS. Results In all the age categories considered, the AUC for TRISS demonstrated high performance (0.935, 0.981, 0.979, and 0.977). The AUC for TRISS was 0.865, 0.585, 0.614, 0.585, 0.591, and 0.600 in Ps-interval groups (0.96–1.00), (0.91–0.95), (0.76. − 0.90), (0.51–0.75), (0.26–0.50), and (0.00–0.25), respectively. In all the age categories considered, the observed survivors among patients with Ps interval (0.00–0.25) were 1.5 times or more than the expected survivors calculated using the TRISS method. Conclusions The TRISS methodology appears to predict survival accurately in Japanese pediatric patients with blunt trauma; however, there were several problems in adopting the TRISS methodology for younger blunt trauma patients with higher injury severity. In the next step, it may be necessary to develop a simple, high-quality prediction model that is more suitable for pediatric trauma patients than the current TRISS model.


2020 ◽  
Vol 7 (4) ◽  
pp. 281-289
Author(s):  
Ki Jeong Hong ◽  
Kyoung Jun Song ◽  
Sang Do Shin ◽  
Young Sun Ro ◽  
Jeong Ho Park ◽  
...  

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Libing Jiang ◽  
Zhongjun Zheng ◽  
Mao Zhang

Abstract Purpose The study aimed to examine the changing incidence of geriatric trauma and evaluate the predictive ability of different scoring tools for in-hospital mortality in geriatric trauma patients. Methods Annual reports released by the National Trauma Database (NTDB) in the USA from 2005 to 2015 and the Trauma Register DGU® in Germany from 1994 to 2012 were analyzed to examine the changing incidence of geriatric trauma. Secondary analysis of a single-center cohort study conducted among 311 severely injured geriatric trauma patients in a level I trauma center in Switzerland was completed. According to the in-hospital survival status, patients were divided into the survival and non-survival group. The differences of the ISS (injury severity score), NISS (new injury severity score), TRISS (Trauma and Injury Severity Score), APACHE II (Acute Physiology and Chronic Health Evaluation II), and SPAS II (simplified acute physiology score II) between two groups were evaluated. Then, the areas under the receiver-operating characteristic curve (AUC-ROC) of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients were calculated. Results The analysis of the NTDB showed that the increase in the number of geriatric trauma ranged from 18 to 30% between 2005 and 2015. The analysis of the DGU® showed that the mean age of trauma patients rose from 39.11 in 1993 to 51.10 in 2013, and the proportion of patients aged ≥ 60 years rose from 16.5 to 37.5%. The findings from the secondary analysis showed that 164 (52.73%) patients died in the hospital. The ISS, NISS, APACHE II, and SAPS II in the death group were significantly higher than those in the survival group, and the TRISS in the death group was significantly lower than those in the survival group. The AUCs of the ISS, NISS, TRISS, APACHE II, and SAPS II for the prediction of in-hospital mortality in geriatric trauma patients were 0.807, 0.850, 0.828, 0.715, and 0.725, respectively. Conclusion The total number of geriatric trauma is increasing as the population ages. The accuracy of ISS, NISS and TRISS was higher than the APACHE II and SAPS II for the prediction of in-hospital mortality in geriatric trauma patients.


Sign in / Sign up

Export Citation Format

Share Document