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Báo cáo y học: "The counterintuitive effect of multiple injuries in severity scoring: a simple variable improves the predictive ability of NISS"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: "The counterintuitive effect of multiple injuries in severity scoring: a simple variable improves the predictive ability of NISS | Di Bartolomeo et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2011 19 26 http www.sjtrem.eom content 19 1 26 SCANDINAVIAN JOURNAL OF Et emergency medicine ORIGINAL RESEARCH Open Access The counterintuitive effect of multiple injuries in severity scoring a simple variable improves the predictive ability of NISS 1 2 2 3 2 Stefano Di Bartolomeo Chiara Ventura Massimiliano Marino Francesca Valent Susanna Trombetti and Rossana De Palma2 Abstract Background Injury scoring is important to formulate prognoses for trauma patients. Although scores based on empirical estimation allow for better prediction those based on expert consensus e.g. the New Injury Severity Score NISS are widely used. We describe how the addition of a variable quantifying the number of injuries improves the ability of NISS to predict mortality. Methods We analyzed 2488 injury cases included into the trauma registry of the Italian region Emilia-Romagna in 2006-2008 and assessed the ability of NISS alone NISS plus number of injuries and the maximum Abbreviated Injury Scale AIS to predict in-hospital mortality. Hierarchical logistic regression was used. We measured discrimination through the C statistics and calibration through Hosmer-Lemeshow statistics Akaike s information criterion AIC and calibration curves. Results The best discrimination and calibration resulted from the model with NISS plus number of injuries followed by NISS alone and then by the maximum AIS C statistics 0.775 0.755 and 0.729 respectively AIC 1602 1635 and 1712 respectively . The predictive ability of all the models improved after inclusion of age gender mechanism of injury and the motor component of Glasgow Coma Scale C statistics 0.889 0.898 and 0.901 AIC 1234 1174 and 1167 . The model with NISS plus number of injuries still showed the best performances this time with borderline statistical significance. Conclusions In NISS the same weight is assigned to the three worst injuries although the .