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. 2021 Dec 7;25(1):420.
doi: 10.1186/s13054-021-03845-6.

Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE

Luis Serviá  1 , Juan Antonio Llompart-Pou  2 , Mario Chico-Fernández  3 , Neus Montserrat  1 , Mariona Badia  1 , Jesús Abelardo Barea-Mendoza  3 , María Ángeles Ballesteros-Sanz  4 , Javier Trujillano  5   6 ; Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)
Affiliations

Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE

Luis Serviá et al. Crit Care. .

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.

Keywords: Intensive care unit; Mortality; Prognostic scoring systems; Trauma and injury severity score.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Probability of death according to the total score. Derivation and validation sets. S: survivors, NS: non-survivors
Fig. 2
Fig. 2
Summary sheet for the RETRASCORE model
Fig. 3
Fig. 3
RETRASCORE risk categories in derivation and validation sets
See this image and copyright information in PMC

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References

    1. Ray JG, Guttmann A, Silveira J, Park AL. Mortality in a cohort of 3.1 million children, adolescents and young adults. J Epidemiol Community Health. 2020;74:260–268. doi: 10.1136/jech-2019-213365. - DOI - PMC - PubMed
    1. De Munter L, Polinder S, Lansink KW, Cnossen MC, Steyerberg EW, de Jongh MA. Mortality prediction models in the general trauma population: a systematic review. Injury. 2017;48:221–229. doi: 10.1016/j.injury.2016.12.009. - DOI - PubMed
    1. Lefering R. Trauma scoring systems. Curr Opin Crit Care. 2012;18:637–640. doi: 10.1097/MCC.0b013e3283585356. - DOI - PubMed
    1. Pino Sánchez FI, Ballesteros Sanz MA, Cordero Lorenzana L, Guerrero López F, Grupo de Trabajo de Trauma y Neurointensivismo de SEMICYUC Quality of trauma care and trauma registries. Med Intensiva. 2015;39:114–123. doi: 10.1016/j.medin.2014.06.008. - DOI - PubMed
    1. Baker SP, O’Neill B, Haddon W, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14:187–196. doi: 10.1097/00005373-197403000-00001. - DOI - PubMed

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