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Open Access 01-12-2021 | Research

Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE

Authors: Luis Serviá, Juan Antonio Llompart-Pou, Mario Chico-Fernández, Neus Montserrat, Mariona Badia, Jesús Abelardo Barea-Mendoza, María Ángeles Ballesteros-Sanz, Javier Trujillano, the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)

Published in: Critical Care | Issue 1/2021

Abstract

Background

Severity scores are commonly used for outcome adjustment and benchmarking of trauma care provided. No specific models performed only with critically ill patients are available. Our objective was to develop a new score for early mortality prediction in trauma ICU patients.

Methods

This is a retrospective study using the Spanish Trauma ICU registry (RETRAUCI) 2015–2019. Patients were divided and analysed into the derivation (2015–2017) and validation sets (2018–2019). We used as candidate variables to be associated with mortality those available in RETRAUCI that could be collected in the first 24 h after ICU admission. Using logistic regression methodology, a simple score (RETRASCORE) was created with points assigned to each selected variable. The performance of the model was carried out according to global measures, discrimination and calibration.

Results

The analysis included 9465 patients: derivation set 5976 and validation set 3489. Thirty-day mortality was 12.2%. The predicted probability of 30-day mortality was determined by the following equation: 1/(1 + exp (− y)), where y = 0.598 (Age 50–65) + 1.239 (Age 66–75) + 2.198 (Age > 75) + 0.349 (PRECOAG) + 0.336 (Pre-hospital intubation) + 0.662 (High-risk mechanism) + 0.950 (unilateral mydriasis) + 3.217 (bilateral mydriasis) + 0.841 (Glasgow ≤ 8) + 0.495 (MAIS-Head) − 0.271 (MAIS-Thorax) + 1.148 (Haemodynamic failure) + 0.708 (Respiratory failure) + 0.567 (Coagulopathy) + 0.580 (Mechanical ventilation) + 0.452 (Massive haemorrhage) − 5.432. The AUROC was 0.913 (0.903–0.923) in the derivation set and 0.929 (0.918–0.940) in the validation set.

Conclusions

The newly developed RETRASCORE is an early, easy-to-calculate and specific score to predict in-hospital mortality in trauma ICU patients. Although it has achieved adequate internal validation, it must be externally validated.

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Title: Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE
Authors: Luis Serviá
Juan Antonio Llompart-Pou
Mario Chico-Fernández
Neus Montserrat
Mariona Badia
Jesús Abelardo Barea-Mendoza
María Ángeles Ballesteros-Sanz
Javier Trujillano
the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2021
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-021-03845-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Development of a new score for early mortality prediction in trauma ICU patients: RETRASCORE

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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