Worthing Physiological Score vs Revised Trauma Score in Outcome Prediction of Trauma patients; a Comparative Study
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e31
https://doi.org/10.22037/aaem.v5i1.155
Abstract
Introduction:Â Awareness about the outcome of trauma patients in the emergency department (ED) has become a topic of interest. Accordingly, the present study aimed to compare the rapid trauma score (RTS) and worthing physiological scoring system (WPSS) in predicting in-hospital mortality and poor outcome of trauma patients.
Methods:Â In this comparative study trauma patients brought to five EDs in different cities of Iran during the year 2016 were included. After data collection, discriminatory power and calibration of the models were assessed and compared using STATA 11.
Results: 2148 patients with the mean age of 39.50±17.27 years were included (75.56% males). The AUC of RTS and WPSS models for prediction of mortality were 0.86 (95% CI: 0.82-0.90) and 0.91 (95% CI: 0.87-0.94), respectively (p=0.006). RTS had a sensitivity of 71.54 (95% CI: 62.59-79.13) and a specificity of 97.38 (95% CI: 96.56-98.01) in prediction of mortality. These measures for the WPSS were 87.80 (95% CI: 80.38-92.78) and 83.45 (95% CI: 81.75-85.04), respectively. The AUC of RTS and WPSS in predicting poor outcome were 0.81 (95% CI: 0.77-0.85) and 0.89 (95% CI: 0.85-0.92), respectively (p<0.0001).
Conclusion:Â The findings showed a higher prognostic value for the WPSS model in predicting mortality and severe disabilities in trauma patients compared to the RTS model. Â Both models had good overall performance in prediction of mortality and poor outcome.
- Trauma Severity Indices
- Prognosis
- Trauma
- emergency department
- decision support techniques
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References
Hosseini M, Ghelichkhani P, Baikpour M, Tafakhori A, Asady H, Ghanbari MJH, et al. Diagnostic Accuracy of Ultrasonography and Radiography in Detection of Pulmonary Contusion; a Systematic Review and Meta-Analysis. Emergency. 2015;3(4):127-36.
Rahimi-Movaghar V, Yousefifard M, Ghelichkhani P, Baikpour M, Tafakhori A, Asady H, et al. Application of Ultrasonography and Radiography in Detection of Hemothorax; a Systematic Review and Meta-Analysis. Emergency. 2016;4(3):116-26.
Safari S, Yousefifard M, Baikpour M, Rahimi-Movaghar V, Abiri S, Falaki M, et al. Validation of thoracic injury rule out criteria as a decision instrument for screening of chest radiography in blunt thoracic trauma. Journal of clinical orthopaedics and trauma. 2016;7(2):95-100.
Safari S, Yousefifard M, Hashemi B, Baratloo A, Forouzanfar MM, Rahmati F, et al. The value of serum creatine kinase in predicting the risk of rhabdomyolysis-induced acute kidney injury: a systematic review and meta-analysis. Clinical and experimental nephrology. 2016;20(2):153-61.
Yousefifard M, Baikpour M, Ghelichkhani P, Asady H, Darafarin A, Amini Esfahani MR, et al. Comparison of Ultrasonography and Radiography in Detection of Thoracic Bone Fractures; a Systematic Review and Meta-Analysis. Emergency. 2016;4(2):55-64.
Yousefifard M, Baikpour M, Ghelichkhani P, Asady H, Darafarin A, Esfahani MRA, et al. Comparison of Ultrasonography and Radiography in Detection of Thoracic Bone Fractures; a Systematic Review and Meta-Analysis. Emergency. 2016;4(2):55-64.
Yousefifard M, Baikpour M, Ghelichkhani P, Asady H, Nia KS, Jafari AM, et al. Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis. Emergency. 2015;3(4):127–36.
Della Corte F, Vignazia G, Cavaglia M. Trauma scoring systems. Anaesthesia, Pain, Intensive Care and Emergency Medicine—APICE: Springer; 2002. p. 351-61.
Lefering R. Trauma scoring systems. Current opinion in critical care. 2012;18(6):637-40.
McEvoy S, Walker SM. Trauma scoring systems. The scientific basis of injury prevention and control. 2004:62-74.
Duckitt R, Buxton-Thomas R, Walker J, Cheek E, Bewick V, Venn R, et al. Worthing physiological scoring system: derivation and validation of a physiological early-warning system for medical admissions. An observational, population-based single-centre study†‡. British journal of anaesthesia. 2007;98(6):769-74.
Gabbe BJ, Cameron PA, Finch CF. Is the revised trauma score still useful? ANZ journal of surgery. 2003;73(11):944-8.
Olsson T, Terént A, Lind L. Rapid Emergency Medicine Score: a new prognostic tool for inâ€hospital mortality in nonsurgical emergency department patients. Journal of internal medicine. 2004;255(5):579-87.
Roorda J, Van Beeck E, Stapert J, Ten Wolde W. Evaluating performance of the revised trauma score as a triage instrument in the prehospital setting. Injury. 1996;27(3):163-7.
de Pennington J, Laurenson J, Lebus C, Sihota S, Smith P. Evaluation of early warning systems on a medical admissions unit. Journal of the Intensive Care Society. 2005;6(2):19-21.
Goldhill D. Preventing surgical deaths: critical care and intensive care outreach services in the postoperative period. British journal of anaesthesia. 2005;95(1):88-94.
Olsson T, Lind L. Comparison of the Rapid Emergency Medicine Score and APACHE II in Nonsurgical Emergency Department Patients. Academic Emergency Medicine. 2003;10(10):1040-8.
Olsson T, Terent A, Lind L. Rapid Emergency Medicine Score Can Predict Long-term Mortality in Nonsurgical Emergency Department Patients. Academic Emergency Medicine. 2004;11(10):1008-13.
Williams E, Subbe C, Gemmell L, Morgan R, Park G, McElligot M, et al. Outreach critical care—cash for no questions? British journal of anaesthesia. 2003;90(5):699-702.
Anderson SI, Housley AM, Jones PA, Slattery J, Miller JD. Glasgow Outcome Scale: an inter-rater reliability study. Brain Injury. 1993;7(4):309-17.
Imhoff BF, Thompson NJ, Hastings MA, Nazir N, Moncure M, Cannon CM. Rapid Emergency Medicine Score (REMS) in the trauma population: a retrospective study. BMJ Open. 2014;4(5).
Cleves MA, Rock L. From the help desk: Comparing areas under receiver operating characteristic curves from two or more probit or logit models. The Stata Journal. 2002;2(3):301-13.
Ha DT, Dang TQ, Tran NV, Vo NY, Nguyen ND, Nguyen TV. Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department. International journal of emergency medicine. 2015;8(1):18.
Brabrand M, Hallas J, Knudsen T. Nurses and Physicians in a Medical Admission Unit Can Accurately Predict Mortality of Acutely Admitted Patients: A Prospective Cohort Study. PLoS ONE. 2014;9(7):e101739.
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