title: Deriving a prediction rule for short stay admission in trauma patients admitted at a major trauma centre in Australia.
abstract: BACKGROUND
  The aim of this study was to derive and internally validate a prediction rule for short stay admissions (SSAs) in trauma patients admitted to a major trauma centre.
  
  
  METHODS
  A retrospective study of all trauma activation patients requiring inpatient admission at a single inner city major trauma centre in Australia between 2007 and 2011 was conducted. Logistic regression was used to derive a multivariable model for the outcome of SSA (length of stay ≤2 days excluding deaths or intensive care unit admission). Model discrimination was tested using area under receiver operator characteristic curve analyses and calibration was tested using the Hosmer-Lemeshow test statistic. Validation was performed by splitting the dataset into derivation and validation datasets and further tested using bootstrap cross validation.
  
  
  RESULTS
  A total of 2593 patients were studied and 30% were classified as SSAs. Important independent predictors of SSA were injury severity score ≤8 (OR 7.8; 95% CI 5.0 to 11.9), Glasgow coma score 14-15 (OR 3.2; 95% CI 1.8 to 5.4), no need for operative intervention (OR 2.2; 95% CI 1.6 to 3.2) and age < 65 years. (OR 1.7; 95% CI 1.2 to 2.6). The overall model had an area under receiver operator characteristic curve of 0.84 (95% CI 0.82 to 0.87) for the derivation dataset. After bootstrap cross validation the area under the curve of the final model was 0.83 (95% CI 0.81 to 0.84).
  
  
  CONCLUSIONS
  We report a prediction rule that could be used to establish admission criteria for a trauma short stay unit. Further studies are required to prospectively validate the prediction rule.
authors: Emergency Department, Royal Prince Alfred Hospital, , Sydney, New South Wales, Australia.
authors: Michael M
authors: MM
authors: Dinh
authors: Kendall J
authors: KJ
authors: Bein
authors: Chris M
authors: CM
authors: Byrne
authors: Belinda
authors: B
authors: Gabbe
authors: Rebecca
authors: R
authors: Ivers
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D019540:Area Under Curve; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014193:Trauma Centers / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D055815:Young Adult
keywords: Trauma; major trauma management