@article{ref1,
title="Simplifying Physiologic Injury Severity Measurement for Predicting Trauma Outcomes",
journal="Journal of surgical research",
year="2010",
author="Oyetunji, Tolulope and Crompton, Joseph G. and Efron, David T. and Haut, Elliott R. and Chang, David C. and Cornwell, Edward E. and Baker, Susan Pardee and Haider, Adil H.",
volume="159",
number="2",
pages="627-632",
abstract="BACKGROUND: The Revised Trauma Score (RTS) is commonly used to assess physiologic injury; however its use is limited by missing data. This study compares different parameters of physiologic injury assessment in their ability to predict mortality after trauma. METHODS: Adult patients in the National Trauma Data Bank (NTDB version 7.0) were analyzed, and the following physiologic injury parameters were compared: RTS, systolic blood pressure (SBP), shock (SBP </= 90 mm Hg), Glasgow coma scale-total (GCS-T), and GCS-motor (GCS-M). Areas under the receiver-operating characteristic curves (AUROC) were calculated for unadjusted and multivariate regression models to predict mortality after trauma. RESULTS: There were 1,484,648 patients who met inclusion criteria. In unadjusted analyses, RTS had the highest proportion of missing data (21%) and was highly predictive of mortality (AUROC = 0.85). SBP and shock had a much lower AUROC of 0.67 and 0.66, respectively, but had many fewer missing cases. The combination parameters of GCS-M with SBP or GCS-M with shock showed AUROC comparable to RTS (0.85) with approximately 80,000 fewer missing cases. CONCLUSION: The discriminatory power of RTS is significantly better than SBP, shock, or GCS alone. Given the limitation of missing data associated with RTS, the combination of SBP and GCS-M is a more reliable and equally effective method of assessing physiologic injury severity in studying trauma outcomes.<p /> <p>Language: en</p>",
language="en",
issn="0022-4804",
doi="10.1016/j.jss.2009.08.026",
url="http://dx.doi.org/10.1016/j.jss.2009.08.026"
}