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J Korean Soc Emerg Med > Volume 31(1); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(1): 111-119.
Performance of four different tools for predicting mortality in elderly patients with severe trauma
Ji Ho Lee , Yong Il Min , Dong Hun Lee , Yong Hun Jung , Kyung Woon Jeung , Byung Kook Lee , Hyoung Youn Lee , Yong Soo Cho , Tag Heo
Department of Emergency Medicine, Chonnam National University School of Medicine, Gwangju, Korea
Correspondence  Yong Il Min ,Tel: 062-220-6809, Fax: 062-228-7417, Email: minyi46@daum.net,
Received: December 11, 2019; Revised: January 22, 2020   Accepted: January 31, 2020.  Published online: February 28, 2020.
The present study aimed to analyze and compare the prognostic performances of Revised Trauma Score (RTS), Injury Severity Score (ISS), shock index (SI), and modified Early Warning Score (MEWS) for in-hospital mortality in severe trauma.
This retrospective observational study included elderly (≥65 years) patients admitted for severe trauma between January 2018 and December 2018. Receiver operating characteristics analysis was performed to examine the prognostic performance of the four different tools. The primary outcome was in-hospital mortality following an injury.
Of the 279 patients included in the study, in-hospital mortality was 20.1% (n=56). In multivariate analysis, age (odds ratio [OR], 1.055; 95% confidence interval [CI], 1.004-1.109), ISS (OR, 1.080; 95% CI, 1.008-1.157), Glasgow Coma Scale (OR, 0.842; 95% CI, 0.785-0.904), and respiratory rate (OR, 1.261; 95% CI, 1.071-1.486) were independently associated with in-hospital mortality. The area under the curves (AUCs) of MEWS, RTS, ISS, and SI were 0.851 (95% CI, 0.763-0.857), 0.733 (0.677-0.784), 0.664 (0.606-0.720), and 0.567 (0.506-0.626), respectively. The AUC of MEWS was significantly different from those of RTS (P=0.034), ISS (P=0.001), and SI (P<0.001).
MEWS has the highest prognostic performance for in-hospital mortality among four different tools in elderly patients with severe trauma.
Key words: Mortality; Trauma; Aged; Trauma severity indices
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