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Open Access 01-12-2017 | Research article

The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction

Authors: Jin Hee Jeong, Yong Joo Park, Dong Hoon Kim, Tae Yun Kim, Changwoo Kang, Soo Hoon Lee, Sang Bong Lee, Seong Chun Kim, Daesung Lim

Published in: BMC Surgery | Issue 1/2017

Abstract

Background

Since its introduction, the Revised Trauma Score (RTS) has been widely used to determine the prognosis of trauma patients. Recent studies have revealed a need to change the parameters of the RTS. We have designed a new trauma score (NTS) based on revised parameters, including the adoption of the actual Glasgow Coma Scale (GCS) score instead of a GCS code, the revision of the systolic blood pressure interval used for the code value and the incorporation of peripheral oxygen saturation (SpO₂) instead of respiratory rate. The purpose of this study was to evaluate the predictive performance of the NTS for in-hospital mortality compared with the RTS and other trauma scores.

Methods

This was a prospective observational study using data from the trauma registry of a tertiary hospital. The subjects were selected from patients who arrived at the ED between July 1, 2014, and June 30, 2016, and, for external validation purposes, those who arrived at the ED between July 1, 2011, and June 30, 2013. Demographic data and physiological data were analyzed. NTS models were calculated using logistic regression for GCS score, SBP code values, and SpO₂. The mortality predictive performance of NTS was compared with that of other trauma scores.

Results

A total of 3263 patients for derivation and 3106 patients for validation were included in the analysis. The NTS showed better discrimination than the RTS (AUC = 0.935 vs. 0.917, respectively, AUC difference = 0.018, p = 0.001; 95% CI, 0.0071–0.0293) and similar discrimination to that of mechanism, Glasgow Coma scale, age, and arterial pressure (MGAP) and the Glasgow Coma Scale, age, and systolic arterial pressure (GAP). In the validation cohort, the global properties of the NTS for mortality prediction were significantly better than those of the RTS (AUC = 0.919 vs. 0.906, respectively; AUC difference = 0.013, p = 0.013; 95% CI, 0.0009–0.0249) and similar to those of the MGAP and GAP.

Conclusions

The NTS predicts in-hospital mortality substantially better than the RTS.

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Title: The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction
Authors: Jin Hee Jeong
Yong Joo Park
Dong Hoon Kim
Tae Yun Kim
Changwoo Kang
Soo Hoon Lee
Sang Bong Lee
Seong Chun Kim
Daesung Lim
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Surgery / Issue 1/2017
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-017-0272-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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