Comparison of the predictive performance of the BIG, TRISS, and PS09 score in an adult trauma population derived from multiple international trauma registries

Brockamp, Thomas; Maegele, Marc; Gaarder, Christine; Goslings, J. C.; Cohen, Mitchell J.; Lefering, Rolf; Joosse, Pieter; Næss, Paal Aksel; Skaga, Nils Oddvar; Groat, Tahnee; Eaglestone, Simon; Borgman, Matthew A.; Spinella, Philip C.; Schreiber, Martin A.; Brohi, Karim

doi:10.1186/cc12813

Cited by 37 publications

(35 citation statements)

References 26 publications

(40 reference statements)

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“…However, neither RTS nor PSS can be used when respiratory rate is missing or not recorded, and hence our models may prove to be feasible alternatives. We have previously highlighted the need for such models [24], as have Kimura et al[23] Also, our models do not require any blood parameters, for example base deficit, that models such as the Admission base deficit, International normalized ratio, and Glasgow Coma Scale (BIG) score require [39].…”

Section: Discussionmentioning

confidence: 93%

Predicting Early Mortality in Adult Trauma Patients Admitted to Three Public University Hospitals in Urban India: A Prospective Multicentre Cohort Study

et al. 2014

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BackgroundIn India alone, more than one million people die yearly due to trauma. Identification of patients at risk of early mortality is crucial to guide clinical management and explain prognosis. Prediction models can support clinical judgement, but existing models have methodological limitations. The aim of this study was to derive a vital sign based prediction model for early mortality among adult trauma patients admitted to three public university hospitals in urban India.MethodsWe conducted a prospective cohort study of adult trauma patients admitted to three urban university hospitals in India between October 2013 and January 2014. The outcome measure was mortality within 24 hours. We used logistic regression with restricted cubic splines to derive our model. We assessed model performance in terms of discrimination, calibration, and optimism.ResultsA total of 1629 patients were included. Median age was 35, 80% were males. Mortality between admission and 24 hours was 6%. Our final model included systolic blood pressure, heart rate, and Glasgow coma scale. Our model displayed good discrimination, with an area under the receiver operating characteristics curve (AUROCC) of 0.85. Predicted mortality corresponded well with observed mortality, indicating good calibration.ConclusionThis study showed that routinely recorded systolic blood pressure, heart rate, and Glasgow coma scale predicted early hospital mortality in trauma patients admitted to three public university hospitals in urban India. Our model needs to be externally validated before it can be applied in the clinical setting.

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Section: Discussionmentioning

confidence: 93%

Predicting Early Mortality in Adult Trauma Patients Admitted to Three Public University Hospitals in Urban India: A Prospective Multicentre Cohort Study

et al. 2014

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“…An adult trauma study made by Brockamp et al ., to compare the BIG score with other trauma scores revealed that BIG score is a good predictor of mortality in the adult trauma population,[27] and they added that in a penetrating trauma population, the BIG score performed better than in a population with blunt trauma. The BIG score has the advantage of being available shortly after admission and may be used to predict clinical prognosis or as a research tool to risk stratify trauma patients into clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Pediatric trauma BIG score: Predicting mortality in polytraumatized pediatric patients

El-Gamasy

Elezz

Basuni

et al. 2016

Indian Journal of Critical Care Medicine

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Background:Trauma is a worldwide health problem and the major cause of death and disability, particularly affecting the young population. It is important to remember that pediatric trauma care has made a significant improvement in the outcomes of these injured children.Aim of the Work:This study aimed at evaluation of pediatric trauma BIG score in comparison with New Injury Severity Score (NISS) and Pediatric Trauma Score (PTS) in Tanta University Emergency Hospital.Materials and Methods:The study was conducted in Tanta University Emergency Hospital to all multiple trauma pediatric patients attended to the Emergency Department for 1 year. Pediatric trauma BIG score, PTS, and NISS scores were calculated and results compared to each other and to observed mortality.Results:BIG score ≥12.7 has sensitivity 86.7% and specificity 71.4%, whereas PTS at value ≤3.5 has sensitivity 63.3% and specificity 68.6% and NISS at value ≥39.5 has sensitivity 53.3% and specificity 54.3%. There was a significant positive correlation between BIG score value and mortality rate.Conclusion:The pediatric BIG score is a reliable mortality-prediction score for children with traumatic injuries; it uses international normalization ratio (INR), Base Excess (BE), and Glasgow Coma Scale (GCS) values that can be measured within a few minutes of sampling, so it can be readily applied in the Pediatric Emergency Department, but it cannot be applied on patients with chronic diseases that affect INR, BE, or GCS.

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“…Quantitative analysis of scale calibration capability is based on comparing the distributions of expected and observed mortality and carried out according to the Hosmer-Lemeshow test. Discrimination ability of prognostic scales based on their sensitivity and specificity is determined by ROC-analysis (receiver operating characteristic curve) with calculating AUC (area under curve) which illustrates predictive value of the scale [12]. When using prognostic systems with a large number of variables, the problem of data insufficiency often occurs.…”

Section: Criteria For Polytrauma and Its Severitymentioning

confidence: 99%

“…The indicators of base deficit, INR and GCS score are included in pediatric trauma BIG score which predicts unfavorable outcome of polytrauma quite accurately in adults as well, particularly, in trauma with penetrating injuries [12].…”

Section: Evaluating the Severity Of Functional Disordersmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of Severity and Prognosis of Polytrauma Outcome: the Current State of the Problem (Review)

Seliverstov¹,

Shapkin²

2017

Sovrem Tehnol Med

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The review deals with modern methods of assessing the severity and predicting the outcome of polytrauma. To solve the problem of objective evaluation of polytrauma severity, numerous studies are devoted to the search for independent predictors of its outcome, many of which are included in various scales and statistical models to quantitatively rank the severity of injury in the established intervals and calculate the survival probability. It is generally accepted to take into account the anatomical criteria to determine the severity of damage, and physiological parameters that characterize the response of the body functional systems to the damage. Age, sex, comorbidities, various clinical parameters, indices of acidosis, coagulopathy, oxidative stress, inflammatory response, timely diagnosing and the quality of treatment, the need of rendering various types of emergency aid are considered as independent risk factors of fatal polytrauma outcome.The predictive value and comparative effectiveness used in polytrauma scales assessing the severity of injuries (ISS, NISS, APS, ICISS, TMPM) and functional disorders (GCS, RTS, APACHE II, MODS II, SOFA, SAPS II, MPM II) as well as a variety of combined clinical and anatomical evaluation systems (TRISS, ASCOT, RISC II, PTS, etc.) are being actively discussed in the modern literature. Creating a universal scale is complicated by a variety of damages and disorders caused by a polytrauma, and insufficient study of injury outcome predictors. The proposed survival rates and prognostic factors are tied to specific polytrauma databases differing in terms of mortality and quality of medical care, which is reflected in their predictive value.A clear definition of polytrauma and formation of a unified system of assessing its severity would allow physicians to standardize treatment policy, objectively solve the problems of organization and financial support of medical help to seriously injured people.Key words: polytrauma; prognostic factors in polytrauma; mortality in polytrauma; scales and systems of injury severity evaluation.For contacts: Pavel A. Seliverstov,

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Comparison of the predictive performance of the BIG, TRISS, and PS09 score in an adult trauma population derived from multiple international trauma registries

Cited by 37 publications

References 26 publications

Predicting Early Mortality in Adult Trauma Patients Admitted to Three Public University Hospitals in Urban India: A Prospective Multicentre Cohort Study

Predicting Early Mortality in Adult Trauma Patients Admitted to Three Public University Hospitals in Urban India: A Prospective Multicentre Cohort Study

Pediatric trauma BIG score: Predicting mortality in polytraumatized pediatric patients

Assessment of Severity and Prognosis of Polytrauma Outcome: the Current State of the Problem (Review)

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