scholarly journals Mortality prediction by ‘Life Threat Index’ compared to widely used trauma scoring systems

Author(s):  
Mariusz Jojczuk ◽  
Adam Nogalski ◽  
Przemysław Krakowski ◽  
Andrzej Prystupa
Author(s):  
Danilo M Razente ◽  
Bruno D Alvarez ◽  
Daniel AM Lacerda ◽  
João MDS Biscardi ◽  
Marcia Olandoski ◽  
...  

ABSTRACT Background This study aims to compare mortality prediction capabilities of three different physiological trauma scoring systems (TSS): Revised Trauma Score (RTS) Glasgow Coma Scale, Age, and Systolic Blood Pressure (GAP) and Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP). Study design A descriptive, cross-sectional study of trauma victims admitted to the emergency service between December-2013 and February-2014. Clinical and epidemiological information were gathered at admission and three TSS were calculated: RTS, GAP, and MGAP. The follow-up period to assess length of hospitalization and mortality lasted until August-2014. Two groups were created — survivals (S) and deaths (D) — and compared. P < 0.05 was considered statistically significant. Results A total of 668 trauma victims were analyzed. The mean age was 37 ± 18 and 69.8% were males. Blunt trauma prevailed (90.6%). The mean scores of RTS, GAP, and MGAP for group S (n = 657; 98.4%) were 7.77 ± 0.33, 22.8 ± 1.7, and 27.4 ± 2.3 respectively (p < 0.001), whereas group D (n = 11, 1.6%) achieved mean scores of 4.57 ± 2.95, 13 ± 7, and 15.5 ± 7 (p < 0.001). Regarding the Receiver Operating Characteristics (ROC) analysis, the areas under the curve were 0.926 (RTS), 0.941 (GAP), and 0.981 (MGAP). The three TSS demonstrated significant mortality prediction capabilities (p < 0.001). There was no statistically significant difference between the three ROC curves (p = 0.138). The MGAP achieved the highest sensitivity (100%), while GAP and RTS sensitivities were 81.8% (59—100%), and 90.9% (73.9—100%) respectively (p < 0.001). The observed specificities were 96.2% (94.77—97.7%) for GAP, 91.6% (89.5—93.7%) for MGAP, and 87.2% (84.7—89.8%) for RTS (p < 0.001). Age (p = 0.049), Glasgow Coma Scale (GCS) (p < 0.001), and trauma mechanism (p < 0.001) were different between the two groups. Conclusion Most patients were young males and victims of blunt trauma. The three TSS demonstrated reliability regarding mortality prediction. The MGAP achieved the highest sensitivity and GAP was the most specific score, which may indicate a potential use of both as valuable alternatives to RTS. How to cite this article Razente DM, Alvarez BD, Lacerda DAM, Biscardi JMDS, Olandoski M, Bahten LCV. Mortality Prediction in Trauma Patients using Three Different Physiological Trauma Scoring Systems. Panam J Trauma Crit Care Emerg Surg 2017;6(3):160-168.


2020 ◽  
Author(s):  
Sepideh Vosooghi Rahbari ◽  
Hamidreza Hosseinpour ◽  
Mohamadreza Karoobi ◽  
Hojat Abolghasemi ◽  
Ali Shahabinezhad ◽  
...  

Abstract background: Trauma is the leading cause of death in people under 40 years of age worldwide. Various studies have been conducted focused on reducing the annual mortality rate due to trauma. One of the most important measures is reducing the time between the incident and the treatment set up, therefore estimation of the severity of trauma and progressing to mortality before further evaluation is justified. Numerous trauma scoring systems have been apllied worldwide as models for predicting mortality of trauma patients in short and long term periods based on clinical and laboratory data. In this study we aim to compare different trauma scoring systems (such as GAP, MGAP, RTS, TRISS) with a relatively new model – Shiraz Trauma Transfusion Score (STTS) – and to discribe the best qualities of these scoring systems for trauma patients in short (less than 24 hours) and long (more than 24 hours) term.Methods: In this cross-sectional study, data from hospitalized trauma patients in Rajaei hospital (center B) of Shiraz, Iran from May to November 2016 were collected and analyzed. Collected data consisted of age, sex, hospital admission duration, mechanism of trauma along with clinical data for calculating different trauma scoring systems, were recorded. Results: while RTS and STTS were the best predictors of mortality in trauma patients in the first 24 hours (sensitivity of 100.00%), GAP and MGAP were the best predictors of the patients’ survival (specificity of 93.83% and 92.59%). GAP and ISS were the best predictors of mortality in trauma patients for more than 24 hours (sensitivity of 82.02%). On the other hand, TRIS and RTS was the best predictors of patients' survival (specificity of 82.59% and 80.26%).Conclusion: Our study findings suggest that the utility and applicability of Shiraz Trauma Transfusion Score(STTS) in predicting mortality is not only comparable with other commonly used scoring methods but it may be of more value in short term mortality prediction.


2021 ◽  
Author(s):  
Sepideh Vosooghi Rahbari ◽  
Hamidreza Hosseinpour ◽  
Mohamadreza Karoobi ◽  
Hojat Abolghasemi ◽  
Ali Shahabinezhad ◽  
...  

Abstract Background: Trauma is the leading cause of death in people under 40 years of age worldwide. Various studies have been conducted focused on reducing the annual mortality rate due to trauma. One of the most important measures is reducing the time between the incident and the treatment set up, therefore estimation of the severity of trauma and progressing to mortality before further evaluation is justified. Numerous trauma scoring systems have been apllied worldwide as models for predicting mortality of trauma patients in short and long term periods based on clinical and laboratory data. In this study we aim to compare different trauma scoring systems (such as GAP, MGAP, RTS, TRISS) with a relatively new model – Shiraz Trauma Transfusion Score (STTS) – and to discribe the best qualities of these scoring systems for trauma patients in short (less than 24 hours) and long (more than 24 hours) term.Methods: In this cross-sectional study, data from hospitalized trauma patients in Rajaei hospital (center B) of Shiraz, Iran from May to November 2016 were collected and analyzed. Collected data consisted of age, sex, hospital admission duration, mechanism of trauma along with clinical data for calculating different trauma scoring systems, were recorded. Results: while RTS and STTS were the best predictors of mortality in trauma patients in the first 24 hours (sensitivity of 100.00%), GAP and MGAP were the best predictors of the patients’ survival (specificity of 93.83% and 92.59%). GAP and ISS were the best predictors of mortality in trauma patients for more than 24 hours (sensitivity of 82.02%). On the other hand, TRIS and RTS was the best predictors of patients' survival (specificity of 82.59% and 80.26%).Conclusions: Our study findings suggest that the utility and applicability of Shiraz Trauma Transfusion Score(STTS) in predicting mortality is not only comparable with other commonly used scoring methods but it may be of more value in short term mortality prediction.


2021 ◽  
Author(s):  
Sepideh Vosooghi Rahbari ◽  
Hamidreza Hosseinpour ◽  
Mohamadreza Karoobi ◽  
Hojat Abolghasemi ◽  
Ali Shahabinezhad ◽  
...  

Abstract Background and Objective: Trauma is the leading cause of death in people under 40 years of age worldwide. Various studies have been conducted focused on reducing the annual mortality rate due to trauma. One of the most important measures is reducing the time between the incident and the treatment set up, therefore the estimation of the severity of trauma and progressing to mortality before further evaluation is justified. In this study, we aim to compare different trauma scoring systems (such as GAP, MGAP, RTS, TRISS) with a relatively new model – Shiraz Trauma Transfusion Score (STTS) – and to describe the best qualities of these scoring systems for trauma patients in short (less than 24 hours) and long (more than 24 hours) term.Methods: In this cross-sectional study, data from hospitalized trauma patients in Rajaei hospital (center B) of Shiraz, Iran from May to November 2016 were collected and analyzed. Collected data consisted of age, sex, hospital admission duration, mechanism of trauma along with clinical data for calculating different trauma scoring systems, were recorded. Results: while RTS and STTS were the best predictors of mortality in trauma patients in the first 24 hours (sensitivity of 100.00%), GAP and MGAP were the best predictors of the patients’ survival (specificity of 93.83% and 92.59%). GAP and ISS were the best predictors of mortality in trauma patients for more than 24 hours (sensitivity of 82.02%). On the other hand, TRIS and RTS were the best predictors of patients' survival (specificity of 82.59% and 80.26%).Conclusions: Our study findings suggest that the utility and applicability of Shiraz Trauma Transfusion Score(STTS) in predicting mortality is not only comparable with other commonly used scoring methods but it may be of more value in shortterm mortality prediction.


2021 ◽  
Author(s):  
Sepideh Vosooghi Rahbari ◽  
Hamidreza Hosseinpour ◽  
Mohamadreza Karoobi ◽  
Hojat Abolghasemi ◽  
Ali Shahabinezhad ◽  
...  

Abstract Background and Objective: Trauma is the leading cause of death in people under 40 years of age worldwide. Various studies have been conducted focused on reducing the annual mortality rate due to trauma. One of the most important measures is reducing the time between the incident and the treatment set up, therefore the estimation of the severity of trauma and progressing to mortality before further evaluation is justified. In this study, we aim to compare different trauma scoring systems (such as GAP, MGAP, RTS, TRISS) with a relatively new model – Shiraz Trauma Transfusion Score (STTS) – and to describe the best qualities of these scoring systems for trauma patients in short (less than 24 hours) and long (more than 24 hours) term.Methods: In this cross-sectional study, data from hospitalized trauma patients in Rajaei hospital (center B) of Shiraz, Iran from May to November 2016 were collected and analyzed. Collected data consisted of age, sex, hospital admission duration, mechanism of trauma along with clinical data for calculating different trauma scoring systems, were recorded. Results: while RTS and STTS were the best predictors of mortality in trauma patients in the first 24 hours (sensitivity of 100.00%), GAP and MGAP were the best predictors of the patients’ survival (specificity of 93.83% and 92.59%). GAP and ISS were the best predictors of mortality in trauma patients for more than 24 hours (sensitivity of 82.02%). On the other hand, TRIS and RTS were the best predictors of patients' survival (specificity of 82.59% and 80.26%).Conclusions: Our study findings suggest that the utility and applicability of Shiraz Trauma Transfusion Score(STTS) in predicting mortality is not only comparable with other commonly used scoring methods but it may be of more value in shortterm mortality prediction.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junkun Liu ◽  
Chengwen Bai ◽  
Binbin Li ◽  
Aijun Shan ◽  
Fei Shi ◽  
...  

AbstractEarly identification of infection severity and organ dysfunction is crucial in improving outcomes of patients with sepsis. We aimed to develop a new combination of blood-based biomarkers that can early predict 28-day mortality in patients with sepsis or septic shock. We enrolled 66 patients with sepsis or septic shock and compared 14 blood-based biomarkers in the first 24 h after ICU admission. The serum levels of interleukin-6 (IL-6) (median 217.6 vs. 4809.0 pg/ml, P = 0.001), lactate (median 2.4 vs. 6.3 mmol/L, P = 0.014), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) (median 1596.5 vs. 32,905.3 ng/ml, P < 0.001), prothrombin time (PT) (median 15.6 vs. 20.1 s, P = 0.030), activated partial thrombin time (APTT) (median 45.1 vs. 59.0 s, P = 0.026), and international normalized ratio (INR) (median 1.3 vs. 1.8, P < 0.001) were significantly lower in the survivor group. IL-6, NT-proBNP, and INR provided the best individual performance in predicting 28-day mortality of patients with sepsis or septic shock. Furthermore, the combination of these three biomarkers achieved better predictive performance (AUC 0.890, P < 0.001) than conventional scoring systems. In summary, the combination of IL-6, NT-proBNP, and INR may serve as a potential predictor of 28-day mortality in critically ill patients with sepsis or septic shock.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Qing Wu ◽  
Jie Wang ◽  
Mengbin Qin ◽  
Huiying Yang ◽  
Zhihai Liang ◽  
...  

Abstract Background Recently, several novel scoring systems have been developed to evaluate the severity and outcomes of acute pancreatitis. This study aimed to compare the effectiveness of novel and conventional scoring systems in predicting the severity and outcomes of acute pancreatitis. Methods Patients treated between January 2003 and August 2020 were reviewed. The Ranson score (RS), Glasgow score (GS), bedside index of severity in acute pancreatitis (BISAP), pancreatic activity scoring system (PASS), and Chinese simple scoring system (CSSS) were determined within 48 h after admission. Multivariate logistic regression was used for severity, mortality, and organ failure prediction. Optimum cutoffs were identified using receiver operating characteristic curve analysis. Results A total of 1848 patients were included. The areas under the curve (AUCs) of RS, GS, BISAP, PASS, and CSSS for severity prediction were 0.861, 0.865, 0.829, 0.778, and 0.816, respectively. The corresponding AUCs for mortality prediction were 0.693, 0.736, 0.789, 0.858, and 0.759. The corresponding AUCs for acute respiratory distress syndrome prediction were 0.745, 0.784, 0.834, 0.936, and 0.820. Finally, the corresponding AUCs for acute renal failure prediction were 0.707, 0.734, 0.781, 0.868, and 0.816. Conclusions RS and GS predicted severity better than they predicted mortality and organ failure, while PASS predicted mortality and organ failure better. BISAP and CSSS performed equally well in severity and outcome predictions.


2014 ◽  
Vol 72 (11) ◽  
pp. 2212-2220 ◽  
Author(s):  
Chen Chen ◽  
Yi Zhang ◽  
Jin-gang An ◽  
Yang He ◽  
Xi Gong

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