title: Comparison of the trauma and injury severity score and modified early warning score with rapid lactate level (the ViEWS-L score) in blunt trauma patients.
abstract: OBJECTIVE
  The aim of this study was to compare the predictive value of the VitalPAC Early Warning Score-lactate (ViEWS-L) score with that of the trauma and injury severity score (TRISS), which is a pre-existing risk scoring system used in trauma patients.
  
  
  METHODS
  The patients were blunt trauma victims admitted consecutively to the study hospital between 1 April 2010 and 31 March 2011, who were 15 years or older and had an injury severity score of 9 or higher. The lactate level, the ViEWS and revised trauma score upon arrival at the emergency department, and the injury severity score and TRISS were evaluated. The ViEWS-L score was calculated according to the formula: ViEWS-L=ViEWS+lactate (mmol/l). The ability to predict mortality was assessed by area under the receiver operating characteristic curve (AUC) analysis and calibration analysis.
  
  
  RESULTS
  A total of 299 patients were available for analysis, of whom 33 died (11.0%). The median ViEWS-L score was 3.7 (interquartile range:1.8-6.4) and the median TRISS was 96.8 (interquartile range: 93.4-98.6). The ViEWS-L score was better than TRISS at predicting hospital mortality (AUC, 0.838; 95% confidence interval, 0.771-0.906 vs. AUC, 0.734; 95% confidence interval, 0.635-0.833, P=0.031). Calibration of the ViEWS-L score (χ=11.13, P=0.194) was good but that of TRISS was not (χ=16.97, P=0.018).
  
  
  CONCLUSIONS
  The prognostic value of the ViEWS-L score in terms of discrimination was better than that of TRISS in the blunt trauma patients admitted to the emergency department with an injury severity score of 9 or higher, and the ViEWS-L score showed good calibration.
authors: aDepartment of Emergency Medicine, Research Institute of Clinical Medicine of Chonbuk National University, Chonbuk National University Hospital, Jeonju bNational Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors: Sion
authors: S
authors: Jo
authors: Jae Baek
authors: JB
authors: Lee
authors: Young Ho
authors: YH
authors: Jin
authors: Taeoh
authors: T
authors: Jeong
authors: Jaechol
authors: J
authors: Yoon
authors: Seok Jin
authors: SJ
authors: Choi
authors: Boyoung
authors: B
authors: Park
mesh_terms: D018806:APACHE; D000046:Academic Medical Centers; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007773:Lactates / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D014949:Wounds, Nonpenetrating / Q000097:blood* / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy
chemical_list: D015415:Biomarkers; D007773:Lactates