The Intermountain Risk Score predicts mortality in trauma patients.
OBJECTIVE
Intermountain Risk Score (IMRS) uses the admission complete blood count and basic metabolic profile to predict mortality. Intermountain Risk Score has been validated in medical patients but has not been evaluated in trauma. This study tested whether IMRS is predictive of mortality in a trauma population at a level I trauma center.


METHODS
Admitted trauma patients with complete blood count and basic metabolic profile from October 2005 to December 2011 were evaluated. Thirty-day and 1-year IMRS were calculated using multivariable modeling. Mortality was determined using the medical record and Social Security Administration death data.


RESULTS
Three thousand six hundred thirty-seven females and 5901 males were evaluated. Intermountain Risk Score was highly predictive of death at 30 days (c-statistics, c = 0.772 for females; c = 0.783 males) and 1 year (c = 0.778 for females; c = 0.831 males). Cox regression analysis, adjusted for injury severity score, blunt vs penetrating, and length of stay, showed increased mortality risks among patients in the moderate- and high-risk IMRS-defined groups at both 30 days and 1 year, with hazard ratios ranging from 4.96 to 57.88 (all P < .001).


CONCLUSIONS
Intermountain Risk Score strongly predicts mortality in trauma patients at this single level I trauma center. The ability to accurately determine a patient's mortality risk at admission makes IMRS a potentially clinically important tool.
Division of Trauma Services and Critical Care Medicine, Intermountain Medical Center, Murray, UT, USA. Electronic address: sarah.majercik@imail.org.
Sarah
S
Majercik
Intermountain Heart Institute, Intermountain Medical Center, Murray, UT, USA, Genetic Epidemiology Division, Department of Medicine, University of Utah, Salt Lake City, UT, USA. Electronic address: Stacey.Knight@imail.org.
Stacey
S
Knight
Intermountain Heart Institute, Intermountain Medical Center, Murray, UT, USA, Genetic Epidemiology Division, Department of Medicine, University of Utah, Salt Lake City, UT, USA. Electronic address: Benjamin.Horne@imail.org.
Benjamin D
BD
Horne
D019540:Area Under Curve; D005260:Female; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012306:Risk; D018570:Risk Assessment; D012737:Sex Factors; D014193:Trauma Centers; D014481:United States; D014949:Wounds, Nonpenetrating / Q000401:mortality*; D014950:Wounds, Penetrating / Q000401:mortality*
Intermountain risk score; Mortality; Scoring systems; Trauma