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A Prospective Multicenter Comparison of Trauma and Injury Severity Score, American Society of Anesthesiologists Physical Status, and National Surgical Quality Improvement Program Calculator's Ability to Predict Operative Trauma Outcomes.

التفاصيل البيبلوغرافية
العنوان: A Prospective Multicenter Comparison of Trauma and Injury Severity Score, American Society of Anesthesiologists Physical Status, and National Surgical Quality Improvement Program Calculator's Ability to Predict Operative Trauma Outcomes.
المؤلفون: Yeates EO; From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California., Nahmias J; From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California., Gabriel V; From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California., Luo X; Department of Anesthesiology, University of Texas Southwestern, Dallas, Texas., Ogunnaike B; Department of Anesthesiology, University of Texas Southwestern, Dallas, Texas., Ahmed MI; Department of Anesthesiology, University of Texas Southwestern, Dallas, Texas., Melikman E; Department of Anesthesiology, University of Texas Southwestern, Dallas, Texas., Moon T; Department of Anesthesiology, University of Texas Southwestern, Dallas, Texas., Shoultz T; Division of Burns, Trauma and Critical Care, Department of Surgery, University of Texas Southwestern, Dallas, Texas., Feeler A; Division of Burns, Trauma and Critical Care, Department of Surgery, University of Texas Southwestern, Dallas, Texas., Dudaryk R; Department of Anesthesiology and Pain Management, University of Miami, Miami, Florida., Navas-Blanco J; Department of Anesthesiology and Pain Management, University of Miami, Miami, Florida., Vasileiou G; Department of Surgery, University of Miami, Miami, Florida., Yeh DD; Department of Surgery, University of Miami, Miami, Florida., Matsushima K; Department of Surgery, University of Southern California, Los Angeles, California., Forestiere M; Department of Surgery, University of Southern California, Los Angeles, California., Lian T; Department of Surgery, University of Southern California, Los Angeles, California., Dominguez OH; From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California.; Department of General Surgery, Cleveland Clinic, Digestive Disease and Surgery Institute, Cleveland, Ohio., Ricks-Oddie JL; Center for Statistical Counseling, University of California, Irvine, Irvine, California.; Institute for Clinical and Translation Sciences, Biostatistics, Epidemiology, and Research Design Unit, University of California, Irvine, Irvine, California., Kuza CM; Department of Anesthesiology, Keck School of Medicine of the University of Southern California, Los Angeles, California.
المصدر: Anesthesia and analgesia [Anesth Analg] 2024 Jun 01; Vol. 138 (6), pp. 1260-1266. Date of Electronic Publication: 2024 May 20.
نوع المنشور: Journal Article; Multicenter Study; Observational Study; Comparative Study
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1310650 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-7598 (Electronic) Linking ISSN: 00032999 NLM ISO Abbreviation: Anesth Analg Subsets: MEDLINE
أسماء مطبوعة: Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins
Original Publication: Cleveland, International Anesthesia Research Society.
مواضيع طبية MeSH: Wounds and Injuries*/surgery , Wounds and Injuries*/mortality , Wounds and Injuries*/diagnosis , Quality Improvement*/standards , Injury Severity Score* , Length of Stay* , Predictive Value of Tests*, Humans ; Prospective Studies ; Male ; Female ; Middle Aged ; Adult ; Aged ; Risk Assessment ; Postoperative Complications/mortality ; Postoperative Complications/etiology ; Postoperative Complications/diagnosis ; Treatment Outcome ; United States/epidemiology ; Risk Factors ; Hospital Mortality ; Anesthesiologists/standards ; Comorbidity ; Trauma Centers/standards
مستخلص: Background: Trauma outcome prediction models have traditionally relied upon patient injury and physiologic data (eg, Trauma and Injury Severity Score [TRISS]) without accounting for comorbidities. We sought to prospectively evaluate the role of the American Society of Anesthesiologists physical status (ASA-PS) score and the National Surgical Quality Improvement Program Surgical Risk-Calculator (NSQIP-SRC), which are measurements of comorbidities, in the prediction of trauma outcomes, hypothesizing that they will improve the predictive ability for mortality, hospital length of stay (LOS), and complications compared to TRISS alone in trauma patients undergoing surgery within 24 hours.
Methods: A prospective, observational multicenter study (9/2018-2/2020) of trauma patients ≥18 years undergoing operation within 24 hours of admission was performed. Multiple logistic regression was used to create models predicting mortality utilizing the variables within TRISS, ASA-PS, and NSQIP-SRC, respectively. Linear regression was used to create models predicting LOS and negative binomial regression to create models predicting complications.
Results: From 4 level I trauma centers, 1213 patients were included. The Brier Score for each model predicting mortality was found to improve accuracy in the following order: 0.0370 for ASA-PS, 0.0355 for NSQIP-SRC, 0.0301 for TRISS, 0.0291 for TRISS+ASA-PS, and 0.0234 for TRISS+NSQIP-SRC. However, when comparing TRISS alone to TRISS+ASA-PS ( P = .082) and TRISS+NSQIP-SRC ( P = .394), there was no significant improvement in mortality prediction. NSQIP-SRC more accurately predicted both LOS and complications compared to TRISS and ASA-PS.
Conclusions: TRISS predicts mortality better than ASA-PS and NSQIP-SRC in trauma patients undergoing surgery within 24 hours. The TRISS mortality predictive ability is not improved when combined with ASA-PS or NSQIP-SRC. However, NSQIP-SRC was the most accurate predictor of LOS and complications.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2023 International Anesthesia Research Society.)
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تواريخ الأحداث: Date Created: 20231213 Date Completed: 20240521 Latest Revision: 20240710
رمز التحديث: 20240710
DOI: 10.1213/ANE.0000000000006802
PMID: 38091502
قاعدة البيانات: MEDLINE
الوصف
تدمد:1526-7598
DOI:10.1213/ANE.0000000000006802