TY - JOUR
T1 - External validation of the Emergency Trauma Score for early prediction of mortality in trauma patients
AU - Joosse, Pieter
AU - de Jong, Willem-Jan J.
AU - Reitsma, Johannes B.
AU - Wendt, Klaus W.
AU - Schep, Niels W.
AU - Goslings, J. Carel
PY - 2014
Y1 - 2014
N2 - The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base excess, and prothrombin time. Our goal was to validate the Emergency Trauma Score in two large external cohorts. As the Injury Severity Score is not accurately known at the time patients present at the resuscitation room, we evaluated the performance of Emergency Trauma Score in all trauma patients. External validation study using data from two prospectively collected trauma registries. Two academic level 1 trauma centers. Adult patients admitted to the hospital after treatment at the trauma resuscitation room. Calibration and discrimination of the original Emergency Trauma Score were assessed within each cohort separately. A total of 4,418 consecutive patients were evaluated. Discrimination was good in both validation cohorts, with areas under the receiver-operating curve curves that were even higher (0.94 and 0.92, respectively) than that in the original cohort (0.83). Predicted mortality was systematically too high compared with actual mortality in patients with low-to-medium expected risk ( <25%). Calibration improved in the lower expected risk range after exclusion of patients with Injury Severity Score less than 16. The Emergency Trauma Score model performs well in discriminating between trauma patients who will survive and who will not. If applied to all trauma patients, predicted mortality risks are too high in the low-risk category
AB - The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base excess, and prothrombin time. Our goal was to validate the Emergency Trauma Score in two large external cohorts. As the Injury Severity Score is not accurately known at the time patients present at the resuscitation room, we evaluated the performance of Emergency Trauma Score in all trauma patients. External validation study using data from two prospectively collected trauma registries. Two academic level 1 trauma centers. Adult patients admitted to the hospital after treatment at the trauma resuscitation room. Calibration and discrimination of the original Emergency Trauma Score were assessed within each cohort separately. A total of 4,418 consecutive patients were evaluated. Discrimination was good in both validation cohorts, with areas under the receiver-operating curve curves that were even higher (0.94 and 0.92, respectively) than that in the original cohort (0.83). Predicted mortality was systematically too high compared with actual mortality in patients with low-to-medium expected risk ( <25%). Calibration improved in the lower expected risk range after exclusion of patients with Injury Severity Score less than 16. The Emergency Trauma Score model performs well in discriminating between trauma patients who will survive and who will not. If applied to all trauma patients, predicted mortality risks are too high in the low-risk category
U2 - https://doi.org/10.1097/CCM.0b013e31829e53f5
DO - https://doi.org/10.1097/CCM.0b013e31829e53f5
M3 - Article
C2 - 23982027
SN - 0090-3493
VL - 42
SP - 83
EP - 89
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 1
ER -