أعرض في EDS

Prediction of intra-hospital mortality after severe trauma: which pre-hospital score is the most accurate?

التفاصيل البيبلوغرافية
العنوان: Prediction of intra-hospital mortality after severe trauma: which pre-hospital score is the most accurate?
المؤلفون: Pierre Bouzat, Pierre Albaladejo, Julien Brun, Pierre Gillois, Robin Legrand, François-Xavier Ageron, Jean François Payen, Dominique Savary, Frederic Champly
المساهمون: Neuro-imagerie fonctionnelle et métabolique (ANTE-INSERM U836, équipe 5), Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Santé Publique, Information médicale et Enseignement multimédia Assisté par Ordinateur (SPI-EAO), Faculté de Médecine [Nancy], Université de Lorraine (UL)-Université de Lorraine (UL), Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Initiatives de Recherche aux Urgences [Paris, France], Société Française de Médecine d'Urgence [Paris, France], Service d'anesthésie-réanimation, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Physiologie cardio-Respiratoire Expérimentale Théorique et Appliquée (TIMC-IMAG-PRETA)
المصدر: Injury
Injury, Elsevier, 2016, 47 (1), pp.14-18. ⟨10.1016/j.injury.2015.10.035⟩
سنة النشر: 2015
مصطلحات موضوعية: Pediatrics, medicine.medical_specialty, Emergency Medical Services, Poison control, Context (language use), 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Outcome Assessment, Health Care, Clinical endpoint, medicine, Humans, Glasgow Coma Scale, 030212 general & internal medicine, Hospital Mortality, ComputingMilieux_MISCELLANEOUS, General Environmental Science, Trauma Severity Indices, Receiver operating characteristic, business.industry, Trauma center, Reproducibility of Results, 030208 emergency & critical care medicine, Triage, ROC Curve, Emergency medicine, Cohort, General Earth and Planetary Sciences, Injury Severity Score, Wounds and Injuries, France, business
الوصف: Computing trauma scores in the field allows immediate severity assessment for appropriate triage. Two pre-hospital scores can be useful in this context: the Triage-Revised Trauma Score (T-RTS) and the Mechanism, Glasgow, Age and arterial Pressure (MGAP) score. The Trauma Revised Injury Severity Score (TRISS), not applicable in the pre-hospital setting, is the reference score to predict in-hospital mortality after severe trauma. The aim of this study was to compare T-RTS, MGAP and TRISS in a cohort of consecutive patients admitted in the Trauma system of the Northern French Alps(TRENAU).From 2009 to 2011, 3260 patients with suspected severe trauma according to the Vittel criteria were included in the TRENAU registry. All data necessary to compute T-RTS, MGAP and TRISS were collected in patients admitted to one level-I, two level-II and ten level-III trauma centers. The primary endpoint was death from any cause during hospital stay. Discriminative power of each score to predict mortality was measured using receiver operating curve (ROC) analysis. To test the relevancy of each score for triage, we also tested their sensitivity at usual cut-offs. We expected a sensitivity higher than 95% to limit undertriage.The TRISS score showed the highest area under the ROC curve (0.95 [CI 95% 0.94-0.97], p0.01). Pre-hospital MGAP score had significantly higher AUC compared to T-RTS (0.93 [CI 95% 0.91-0.95] vs 0.86 [CI 95% 0.83-0.89], respectively, p0.01). MGAP score23 had a sensitivity of 88% to detect mortality. Sensitivities of T-RTS12 and TRISS0.91 were 79% and 87%, respectively.Pre-hospital calculation of the MGAP score appeared superior to T-RTS score in predicting intra-hospital mortality in a cohort of trauma patients. Although TRISS had the highest AUC, this score can only be available after hospital admission. These findings suggest that the MGAP score could be of interest in the pre-hospital setting to assess patients' severity. However, its lack of sensitivity indicates that MGAP should not replace the decision scheme to direct the most severe patients to level-I trauma center.
تدمد: 1879-0267
0020-1383
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::650c8b35304faa17fd9d3bb0a72534aa
https://pubmed.ncbi.nlm.nih.gov/27401030
حقوق: CLOSED
رقم الأكسشن: edsair.doi.dedup.....650c8b35304faa17fd9d3bb0a72534aa
قاعدة البيانات: OpenAIRE
الوصف
تدمد:18790267
00201383