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Revised trauma scoring system to predict in-hospital mortality in the emergency department: Glasgow Coma Scale, Age, and Systolic Blood Pressure score
http://hdl.handle.net/2241/116820
http://hdl.handle.net/2241/11682068a9e66a-06e6-45a2-ba66-fe7297c82870
名前 / ファイル | ライセンス | アクション |
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CC_15-4.pdf (259.7 kB)
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Item type | Journal Article(1) | |||||
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公開日 | 2012-04-12 | |||||
タイトル | ||||||
タイトル | Revised trauma scoring system to predict in-hospital mortality in the emergency department: Glasgow Coma Scale, Age, and Systolic Blood Pressure score | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_6501 | |||||
タイプ | journal article | |||||
著者 |
Kondo, Yutaka
× Kondo, Yutaka× Abe, Toshikazu× Kohshi, Kiyotaka× Tokuda, Yasuharu× Cook, E Francis× Kukita, Ichiro |
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著者別名 |
阿部, 智一
× 阿部, 智一× 徳田, 安春 |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Introduction: Our aim in this study was to assess whether the new Glasgow Coma Scale, Age, and Systolic Blood Pressure (GAP) scoring system, which is a modification of the Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP) scoring system, better predicts in-hospital mortality and can be applied more easily than previous trauma scores among trauma patients in the emergency department (ED). Methods:This multicenter, prospective, observational study was conducted to analyze readily available variables in the ED, which are associated with mortality rates among trauma patients. The data used in this study were derived from the Japan Trauma Data Bank (JTDB), which consists of 114 major emergency hospitals in Japan. A total of 35,732 trauma patients in the JTDB from 2004 to 2009 who were 15 years of age or older were eligible for inclusion in the study. Of these patients, 27,154 (76%) with complete sets of important data (patient age, Glasgow Coma Scale (GCS) score, systolic blood pressure (SBP), respiratory rate and Injury Severity Score (ISS)) were included in our analysis. We calculated weight for the predictors of the GAP scores on the basis of the records of 13,463 trauma patients in a derivation data set determined by using logistic regression. Scores derived from four existing scoring systems (Revised Trauma Score, Triage Revised Trauma Score, Trauma and Injury Severity Score and MGAP score) were calibrated using logistic regression models that fit in the derivation set. The GAP scoring system was compared to the calibrated scoring systems with data from a total of 13,691 patients in a validation data set using c-statistics and reclassification tables with three defined risk groups based on a previous publication: low risk (mortality < 5%), intermediate risk, and high risk (mortality > 50%). Results:Calculated GAP scores involved GCS score (from three to fifteen points), patient age < 60 years (three points) and SBP (> 120 mmHg, six points; 60 to 120 mmHg, four points). The c-statistics for the GAP scores (0.933 for long-term mortality and 0.965 for short-term mortality) were better than or comparable to the trauma scores calculated using other scales. Compared with existing instruments, our reclassification tables show that the GAP scoring system reclassified all patients except one in the correct direction. In most cases, the observed incidence of death in patients who were reclassified matched what would have been predicted by the GAP scoring system. Conclusions:The GAP scoring system can predict in-hospital mortality more accurately than the previously developed trauma scoring systems. |
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書誌情報 |
Critical care 巻 15, 号 4, p. R191, 発行日 2011-08 |
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ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 1364-8535 | |||||
書誌レコードID | ||||||
収録物識別子タイプ | NCID | |||||
収録物識別子 | AA11695602 | |||||
PubMed番号 | ||||||
識別子タイプ | PMID | |||||
関連識別子 | 21831280 | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1186/cc10348 | |||||
権利 | ||||||
権利情報 | © 2011 Kondo et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. | |||||
著者版フラグ | ||||||
値 | publisher | |||||
出版者 | ||||||
出版者 | BioMed Central Ltd. | |||||
URI | ||||||
識別子 | http://hdl.handle.net/2241/116820 | |||||
識別子タイプ | HDL |