@article{ref1,
title="A comparison of prognosis calculators for geriatric trauma: A P.A.L.LI.A.T.E. consortium study",
journal="Journal of trauma and acute care surgery",
year="2017",
author="Madni, Tarik D. and Ekeh, Akpofure Peter and Brakenridge, Scott C. and Brasel, Karen J. and Joseph, Bellal and Inaba, Kenji and Bruns, Brandon R. and Kerby, Jeffrey D. and Cuschieri, Joseph and Mohler, M. Jane and Nakonezny, Paul A. and Clark, Audra and Imran, Jonathan and Wolf, Steven E. and Paulk, M. Elizabeth and Rhodes, Ramona L. and Phelan, Herb A.",
volume="83",
number="1",
pages="90-96",
abstract="BACKGROUND: The nine-center PALLIATE consortium has validated the Geriatric Trauma Outcome Score (GTOS) as a prognosis calculator for injured elders. We compared GTOS' performance to that of the Trauma Injury Severity Score (TRISS) in a multicenter sample. <br><br>METHODS: Three PALLIATE centers not submitting subjects to the GTOS validation study identified subjects aged 65 to 102 yrs admitted from 2000-2013. GTOS was specified using the formula [GTOS = age + (ISS x 2.5) + 22 (if transfused packed red cells (PRC) at 24 hrs)]. TRISS uses the Revised Trauma Score (RTS), dichotomizes age (<55 yrs=0 and ≥55 yrs=1), and was specified using the updated 1995 beta coefficients. TRISS Penetrating was specified as [TRISSP = -2.5355 + (0.9934 x RTS) + (-0.0651 x ISS) + (-1.1360 x Age)]. TRISS Blunt was specified as [TRISSB = -0.4499 + (0.8085 x RTS Total) + (-0.0835 x ISS) + (-1.7430 x Age)]. Each then became the sole predictor in a separate logistic regression model to estimate probability of mortality. Model performances were evaluated using misclassification rate, Brier score, and Area Under the Curve (AUC). <br><br>RESULTS: Demographics (mean + SD) of subjects with complete data (N=10,894) were age=78.3 yrs±8.1; ISS=10.9±8.4; RTS=7.5±1.1; mortality=6.9%; blunt mechanism=98.6%; 3.1 % of subjects received PRCs. The penetrating trauma sub-sample (n=150) had a higher mortality rate of 20.0%. The misclassification rates for the models were GTOS=0.065, TRISSB=0.051, and TRISSP=0.120. Brier scores were GTOS=0.052, TRISSB=0.041, and TRISSP=0.084. The AUCs were GTOS=0.844, TRISSB=0.889, and TRISSP=0.897. <br><br>CONCLUSIONS: GTOS and TRISS function similarly and accurately in predicting probability of death for injured elders. GTOS has the advantages of a single formula, fewer variables, and no reliance on data collected in the Emergency Room or by other observers. LEVEL OF EVIDENCE: Level II, prognostic.<p /> <p>Language: en</p>",
language="en",
issn="2163-0755",
doi="10.1097/TA.0000000000001506",
url="http://dx.doi.org/10.1097/TA.0000000000001506"
}