title: Scoring severity in trauma: comparison of prehospital scoring systems in trauma ICU patients.
abstract: OBJECTIVE
  We evaluated the predictive ability of mechanism, Glasgow coma scale, age and arterial pressure (MGAP), Glasgow coma scale, age and systolic blood pressure (GAP), and triage-revised trauma Score (T-RTS) scores in patients from the Spanish trauma ICU registry using the trauma and injury severity score (TRISS) as a reference standard.
  
  
  METHODS
  Patients admitted for traumatic disease in the participating ICU were included. Quantitative data were reported as median [interquartile range (IQR), categorical data as number (percentage)]. Comparisons between groups with quantitative variables and categorical variables were performed using Student's T Test and Chi Square Test, respectively. We performed receiving operating curves (ROC) and evaluated the area under the curve (AUC) with its 95 % confidence interval (CI). Sensitivity, specificity, positive predictive and negative predictive values and accuracy were evaluated in all the scores. A value of p < 0.05 was considered significant.
  
  
  RESULTS
  The final sample included 1361 trauma ICU patients. Median age was 45 (30-61) years. 1092 patients (80.3 %) were male. Median ISS was 18 (13-26) and median T-RTS was 11 (10-12). Median GAP was 20 (15-22) and median MGAP 24 (20-27). Observed mortality was 17.7 % whilst predicted mortality using TRISS was 16.9 %. The AUC in the scores evaluated was: TRISS 0.897 (95 % CI 0.876-0.918), MGAP 0.860 (95 % CI 0.835-0.886), GAP 0.849 (95 % CI 0.823-0.876) and T-RTS 0.796 (95 % CI 0.762-0.830).
  
  
  CONCLUSIONS
  Both MGAP and GAP scores performed better than the T-RTS in the prediction of hospital mortality in Spanish trauma ICU patients. Since these are easy-to-perform scores, they should be incorporated in clinical practice as a triaging tool.
authors.affiliation: Servei de Medicina Intensiva, Hospital Universitari Son Espases, Carretera Valldemossa, 79, 07010, Palma de Mallorca, Spain. juanantonio.llompart@ssib.es.
authors.forename: J A
authors.initials: JA
authors.lastname: Llompart-Pou
authors.affiliation: UCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Chico-Fernández
authors.affiliation: Servicio de Medicina Intensiva, Hospital Virgen de la Salud, Toledo, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Casado
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Donostia, San Sebastián, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Salaberria-Udabe
authors.affiliation: Servicio de Medicina Intensiva, Complejo Hospitalario de Torrecárdenas, Almería, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Carbayo-Górriz
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Virgen de las Nieves, Granada, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Guerrero-López
authors.affiliation: Servicio de Medicina Intensiva, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
authors.forename: J
authors.initials: J
authors.lastname: González-Robledo
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: M Á
authors.initials: MÁ
authors.lastname: Ballesteros-Sanz
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Valladolid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Herrán-Monge
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Servià-Goixart
authors.affiliation: Servicio de Medicina Intensiva, Ciudad Sanitaria Reina Sofia, Córdoba, Spain.
authors.forename: R
authors.initials: R
authors.lastname: León-López
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Miguel Servet, Zaragoza, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Val-Jordán
mesh_terms: D000328:Adult; D019540:Area Under Curve; D019985:Benchmarking; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012372:ROC Curve; D012042:Registries; D012680:Sensitivity and Specificity; D013030:Spain; D014218:Triage / Q000592:standards
keywords: Mortality prediction; Scales; Scoring; Trauma