Citation

Kuza CM, Matsushima K, Mack WJ, Pham C, Hourany T, Lee J, Tran TD, Dudaryk R, Mulder MB, Escanelle MA, Ogunnaike B, Ahmed MI, Luo X, Eastman A, Imran JB, Melikman E, Minhajuddin A, Feeler A, Urman RD, Salim A, Spencer D, Gabriel V, Ramakrishnan D, Nahmias JT. Am. J. Surg. 2019; ePub(ePub): ePub.

Affiliation

Department of Surgery, Division of Trauma, Burns, & Surgical Critical Care, University of California, Irvine, 333 City Blvd. West, Suite 1600, Orange, CA, 92868, USA.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2019.09.019

PMID

31575418

Abstract

BACKGROUND: Trauma prediction scores such as Revised Trauma Score (RTS) and Trauma and Injury Severity Score (TRISS)) are used to predict mortality, but do not include comorbidities. We analyzed the American Society of Anesthesiologists physical status (ASA PS) for predicting mortality in trauma patients undergoing surgery.

METHODS: This multicenter, retrospective study compared the mortality predictive ability of ASA PS, RTS, Injury Severity Score (ISS), and TRISS using a complete case analysis with mixed effects logistic regression. Associations with mortality and AROC were calculated for each measure alone and tested for differences using chi-square.

RESULTS: Of 3,042 patients, 230 (8%) died. The AROC for mortality for TRISS was 0.938 (95%CI 0.921, 0.954), RTS 0.845 (95%CI 0.815, 0.875), and ASA PS 0.886 (95%CI 0.864, 0.908). ASA PS + TRISS did not improve mortality predictive ability (p = 0.18).

CONCLUSIONS: ASA PS was a good predictor of mortality in trauma patients, although combined with TRISS it did not improve predictive ability.

Copyright © 2019 Elsevier Inc. All rights reserved.

Language: en

Keywords

ASA PS; Mortality; Outcomes; Predictors; Trauma scores