A new "TRISS-like" probability of survival model for intubated trauma patients.
BACKGROUND
Prehospital trauma patient field intubations and paralyzations, using neuromuscular blocking agents before emergency department respiratory and neurologic assessments are made, bias assessments and outcome evaluations using probability-of-survival models, such as TRISS and A Severity Characterization of Trauma (ASCOT). We present a newly developed "TRISS-like" probability-of-survival model for intubated blunt- and penetrating-injured patient assessment.


METHODS
From a population of 51397 consecutively admitted trauma patients, this study used all 5740 (11.2% of the total injured population) intubated patients with complete data from a statewide trauma registry from October 1, 1993, to September 30, 1996. Model performance was evaluated using standard calibration and discrimination measures and z and W statistics of significance.


RESULTS
The new model accurately predicted survival for blunt- and penetrating-injured intubated patients and is applicable to 11 etiologic patient populations.


CONCLUSIONS
Study findings suggest that the new TRISS-like model should be used to assess both blunt- and penetrating-injured intubated patients. Use of this new model provides an analytical method for addressing a significant limitation of both the standard TRISS and ASCOT models, which are not applicable to intubated injured patient assessment. In addition, use of this model will complement TRISS/ASCOT assessments of nonintubated trauma patients and thus permit appropriate assessments for both intubated and nonintubated injured patient study populations.
Davis
Edward G
EG
Bloomberg School of Public Health, Department of Environmental Health Sciences, Johns Hopkins University, Baltimore, MD, USA.
MacKenzie
Ellen J
EJ
Sacco
William J
WJ
Bain
Lawrence W
LW
Buckman
Robert F
RF
Champion
Howard R
HR
Lees
Peter S J
PS
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008875:Middle Aged; D015233:Models, Statistical; D010414:Pennsylvania; D011336:Probability; D012042:Registries; D016019:Survival Analysis; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000145:classification / Q000209:etiology / Q000401:mortality*