Cargando…
The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction
BACKGROUND: Since its introduction, the Revised Trauma Score (RTS) has been widely used to determine the prognosis of trauma patients. Recent studies have revealed a need to change the parameters of the RTS. We have designed a new trauma score (NTS) based on revised parameters, including the adoptio...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496419/ https://www.ncbi.nlm.nih.gov/pubmed/28673278 http://dx.doi.org/10.1186/s12893-017-0272-4 |
_version_ | 1783247977175842816 |
---|---|
author | Jeong, Jin Hee Park, Yong Joo Kim, Dong Hoon Kim, Tae Yun Kang, Changwoo Lee, Soo Hoon Lee, Sang Bong Kim, Seong Chun Lim, Daesung |
author_facet | Jeong, Jin Hee Park, Yong Joo Kim, Dong Hoon Kim, Tae Yun Kang, Changwoo Lee, Soo Hoon Lee, Sang Bong Kim, Seong Chun Lim, Daesung |
author_sort | Jeong, Jin Hee |
collection | PubMed |
description | BACKGROUND: Since its introduction, the Revised Trauma Score (RTS) has been widely used to determine the prognosis of trauma patients. Recent studies have revealed a need to change the parameters of the RTS. We have designed a new trauma score (NTS) based on revised parameters, including the adoption of the actual Glasgow Coma Scale (GCS) score instead of a GCS code, the revision of the systolic blood pressure interval used for the code value and the incorporation of peripheral oxygen saturation (SpO(2)) instead of respiratory rate. The purpose of this study was to evaluate the predictive performance of the NTS for in-hospital mortality compared with the RTS and other trauma scores. METHODS: This was a prospective observational study using data from the trauma registry of a tertiary hospital. The subjects were selected from patients who arrived at the ED between July 1, 2014, and June 30, 2016, and, for external validation purposes, those who arrived at the ED between July 1, 2011, and June 30, 2013. Demographic data and physiological data were analyzed. NTS models were calculated using logistic regression for GCS score, SBP code values, and SpO(2). The mortality predictive performance of NTS was compared with that of other trauma scores. RESULTS: A total of 3263 patients for derivation and 3106 patients for validation were included in the analysis. The NTS showed better discrimination than the RTS (AUC = 0.935 vs. 0.917, respectively, AUC difference = 0.018, p = 0.001; 95% CI, 0.0071–0.0293) and similar discrimination to that of mechanism, Glasgow Coma scale, age, and arterial pressure (MGAP) and the Glasgow Coma Scale, age, and systolic arterial pressure (GAP). In the validation cohort, the global properties of the NTS for mortality prediction were significantly better than those of the RTS (AUC = 0.919 vs. 0.906, respectively; AUC difference = 0.013, p = 0.013; 95% CI, 0.0009–0.0249) and similar to those of the MGAP and GAP. CONCLUSIONS: The NTS predicts in-hospital mortality substantially better than the RTS. |
format | Online Article Text |
id | pubmed-5496419 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-54964192017-07-07 The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction Jeong, Jin Hee Park, Yong Joo Kim, Dong Hoon Kim, Tae Yun Kang, Changwoo Lee, Soo Hoon Lee, Sang Bong Kim, Seong Chun Lim, Daesung BMC Surg Research Article BACKGROUND: Since its introduction, the Revised Trauma Score (RTS) has been widely used to determine the prognosis of trauma patients. Recent studies have revealed a need to change the parameters of the RTS. We have designed a new trauma score (NTS) based on revised parameters, including the adoption of the actual Glasgow Coma Scale (GCS) score instead of a GCS code, the revision of the systolic blood pressure interval used for the code value and the incorporation of peripheral oxygen saturation (SpO(2)) instead of respiratory rate. The purpose of this study was to evaluate the predictive performance of the NTS for in-hospital mortality compared with the RTS and other trauma scores. METHODS: This was a prospective observational study using data from the trauma registry of a tertiary hospital. The subjects were selected from patients who arrived at the ED between July 1, 2014, and June 30, 2016, and, for external validation purposes, those who arrived at the ED between July 1, 2011, and June 30, 2013. Demographic data and physiological data were analyzed. NTS models were calculated using logistic regression for GCS score, SBP code values, and SpO(2). The mortality predictive performance of NTS was compared with that of other trauma scores. RESULTS: A total of 3263 patients for derivation and 3106 patients for validation were included in the analysis. The NTS showed better discrimination than the RTS (AUC = 0.935 vs. 0.917, respectively, AUC difference = 0.018, p = 0.001; 95% CI, 0.0071–0.0293) and similar discrimination to that of mechanism, Glasgow Coma scale, age, and arterial pressure (MGAP) and the Glasgow Coma Scale, age, and systolic arterial pressure (GAP). In the validation cohort, the global properties of the NTS for mortality prediction were significantly better than those of the RTS (AUC = 0.919 vs. 0.906, respectively; AUC difference = 0.013, p = 0.013; 95% CI, 0.0009–0.0249) and similar to those of the MGAP and GAP. CONCLUSIONS: The NTS predicts in-hospital mortality substantially better than the RTS. BioMed Central 2017-07-03 /pmc/articles/PMC5496419/ /pubmed/28673278 http://dx.doi.org/10.1186/s12893-017-0272-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Jeong, Jin Hee Park, Yong Joo Kim, Dong Hoon Kim, Tae Yun Kang, Changwoo Lee, Soo Hoon Lee, Sang Bong Kim, Seong Chun Lim, Daesung The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction |
title | The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction |
title_full | The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction |
title_fullStr | The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction |
title_full_unstemmed | The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction |
title_short | The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction |
title_sort | new trauma score (nts): a modification of the revised trauma score for better trauma mortality prediction |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496419/ https://www.ncbi.nlm.nih.gov/pubmed/28673278 http://dx.doi.org/10.1186/s12893-017-0272-4 |
work_keys_str_mv | AT jeongjinhee thenewtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT parkyongjoo thenewtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT kimdonghoon thenewtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT kimtaeyun thenewtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT kangchangwoo thenewtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT leesoohoon thenewtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT leesangbong thenewtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT kimseongchun thenewtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT limdaesung thenewtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT jeongjinhee newtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT parkyongjoo newtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT kimdonghoon newtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT kimtaeyun newtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT kangchangwoo newtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT leesoohoon newtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT leesangbong newtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT kimseongchun newtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction AT limdaesung newtraumascorentsamodificationoftherevisedtraumascoreforbettertraumamortalityprediction |