Is the Trauma Mortality Prediction Model (TMPM-ICD-9) a valid predictor of mortality in pediatric trauma patients?
OBJECTIVE
Researchers are constantly challenged to identify optimal mortality risk adjustment methodologies that perform accurately in pediatric trauma patients. This study evaluated the new Trauma Mortality Prediction Model (TMPM-ICD-9) in pediatric trauma patients.


METHODS
Data were analyzed on 107,104 pediatric trauma patients included in the NTDB® in 2010 who had both a valid ISS and probability of death using TMPM-ICD-9. Discrimination was compared using the area under the receiver operator characteristic curve (AUC) and by age, blunt vs penetrating, intent, Glasgow Coma Scale (GCS), and number of injuries.


RESULTS
The AUC for TMPM-ICD-9 demonstrated excellent discrimination in predicting mortality versus ISS overall, 11 to 17years of age (0.96 vs 0.93), by injury type, intent, and in the lowest GCS scores. The TMPM-ICD-9 showed superior discrimination over ISS in patients with more than two injuries.


CONCLUSIONS
The TMPM demonstrated superior discrimination compared to ISS. The TMPM shows promise of a much needed and simple to use risk adjustment tool with application to both adult and pediatric patients. Researchers should continue to validate this tool in robust pediatric data sets.
Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: lcassidy@mcw.edu.
Laura D
LD
Cassidy
Baylor University Medical Center.
Alan
A
Cook
Medical College of Wisconsin, Milwaukee, WI, USA.
Allison
A
Ertl
Medical College of Wisconsin, Milwaukee, WI, USA.
David
D
Gourlay
University of Vermont.
Turner
T
Osler
D000293:Adolescent; D017677:Age Distribution; D019540:Area Under Curve; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D038801:International Classification of Diseases; D008297:Male; D008962:Models, Theoretical; D009104:Multiple Trauma / Q000401:mortality; D011379:Prognosis; D012372:ROC Curve; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000401:mortality*; D014949:Wounds, Nonpenetrating / Q000401:mortality; D014950:Wounds, Penetrating / Q000401:mortality
Injury severity score; NTDB; Pediatric trauma; TMPM-ICD-9