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Accuracy of different survival prediction models in a trauma population
- Source :
- British Journal of Surgery. 97:1805-1813
- Publication Year :
- 2010
- Publisher :
- Oxford University Press (OUP), 2010.
-
Abstract
- Background There is growing demand for a simple accurate scoring model to evaluate the quality of trauma care. This study compared different trauma survival prediction models with regard to their performance in different trauma populations. Methods The probability of survival for 10 777 trauma patients admitted to hospital was calculated using the formulas of the following models: the Major Trauma Outcome Study (MTOS), the Trauma Audit and Research Network (TARN) and the Base Excess Injury Severity Scale (BISS). Updated coefficients were calculated by logistic regression analysis based on a Dutch data set. Different models were compared for several subsets of patients, according to age and injury type and severity, using the area under the receiver operating characteristic (ROC) curve (AUC). Calibration for the updated models was presented graphically. Results Most of the models had an AUC exceeding 0·8. For the total population, the TARN Ps07 model with updated coefficients had the highest AUC (0·924); for the subset of patients in whom all parameters were available, the BISS model including the Glasgow Coma Scale had the highest AUC (0·909). All of the models had high discriminative power for patients aged less than 55 years. However, in older or intubated patients and in those with severe head injuries the discriminative power of the models dropped. The TARN model showed the best accuracy. Conclusion The investigated models predict mortality fairly accurately in a Dutch trauma population. However, the accuracy of the models depends greatly on the patients included. Severe head injuries and greater age are likely to lead to a decrease in the accuracy of survival prediction.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Population
Poison control
Logistic regression
Young Adult
Injury prevention
medicine
Humans
Child
education
Aged
Aged, 80 and over
education.field_of_study
Receiver operating characteristic
business.industry
Major trauma
Glasgow Coma Scale
Middle Aged
medicine.disease
Surgery
Hospitalization
Child, Preschool
Emergency medicine
Wounds and Injuries
Injury Severity Score
Female
Epidemiologic Methods
business
Subjects
Details
- ISSN :
- 13652168 and 00071323
- Volume :
- 97
- Database :
- OpenAIRE
- Journal :
- British Journal of Surgery
- Accession number :
- edsair.doi.dedup.....fd78eb47424b1b45f218bf2778f8aec6
- Full Text :
- https://doi.org/10.1002/bjs.7216