Revised trauma scoring system to predict in-hospital mortality in the emergency department Glasgow Coma Scale, Age, and Systolic Blood Pressure score 英文参考文献.docVIP

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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 英文参考文献.doc

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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 英文参考文献

Kondoetal.CriticalCare2011,15:R191 /content/15/4/R191 RESEARCH OpenAccess Revisedtraumascoringsystemtopredict in-hospitalmortalityintheemergency department:GlasgowComaScale,Age,and SystolicBloodPressurescore YutakaKondo1,ToshikazuAbe2*,KiyotakaKohshi3,YasuharuTokuda4,EFrancisCook5andIchiroKukita1 Abstract Introduction:OuraiminthisstudywastoassesswhetherthenewGlasgowComaScale,Age,andSystolicBlood Pressure(GAP)scoringsystem,whichisamodificationoftheMechanism,GlasgowComaScale,Age,andArterial Pressure(MGAP)scoringsystem,betterpredictsin-hospitalmortalityandcanbeappliedmoreeasilythanprevious traumascoresamongtraumapatientsintheemergencydepartment(ED). Methods:Thismulticenter,prospective,observationalstudywasconductedtoanalyzereadilyavailablevariablesin theED,whichareassociatedwithmortalityratesamongtraumapatients.Thedatausedinthisstudywerederived fromtheJapanTraumaDataBank(JTDB),whichconsistsof114majoremergencyhospitalsinJapan.Atotalof 35,732traumapatientsintheJTDBfrom2004to2009whowere15yearsofageorolderwereeligiblefor inclusioninthestudy.Ofthesepatients,27,154(76%)withcompletesetsofimportantdata(patientage,Glasgow ComaScale(GCS)score,systolicbloodpressure(SBP),respiratoryrateandInjurySeverityScore(ISS))wereincluded inouranalysis.WecalculatedweightforthepredictorsoftheGAPscoresonthebasisoftherecordsof13,463 traumapatientsinaderivationdatasetdeterminedbyusinglogisticregression.Scoresderivedfromfourexisting scoringsystems(RevisedTraumaScore,TriageRevisedTraumaScore,TraumaandInjurySeverityScoreandMGAP score)werecalibratedusinglogisticregressionmodelsthatfitinthederivationset.TheGAPscoringsystemwas comparedtothecalibratedscoringsystemswithdatafromatotalof13,691patientsinavalidationdatasetusing c-statisticsandreclassificationtableswiththreedefinedriskgroupsbasedonapreviouspublication:lowrisk (mortality5%),intermediaterisk,andhighrisk(mortality50%). Results:CalculatedGAPscoresinvolvedGCSscore(fromthreetofifteenpoints),patientage60years(three points)andSBP(120mmHg,sixpoints;6