title: Mortality prediction using TRISS methodology in the Spanish ICU Trauma Registry (RETRAUCI).
abstract: OBJECTIVE
  To validate Trauma and Injury Severity Score (TRISS) methodology as an auditing tool in the Spanish ICU Trauma Registry (RETRAUCI).
  
  
  METHODS
  A prospective, multicenter registry evaluation was carried out.
  
  
  METHODS
  Thirteen Spanish Intensive Care Units (ICUs).
  
  
  METHODS
  Individuals with traumatic disease and available data admitted to the participating ICUs.
  
  
  METHODS
  Predicted mortality using TRISS methodology was compared with that observed in the pilot phase of the RETRAUCI from November 2012 to January 2015. Discrimination was evaluated using receiver operating characteristic (ROC) curves and the corresponding areas under the curves (AUCs) (95% CI), with calibration using the Hosmer-Lemeshow (HL) goodness-of-fit test. A value of p<0.05 was considered significant.
  
  
  METHODS
  Predicted and observed mortality.
  
  
  RESULTS
  A total of 1405 patients were analyzed. The observed mortality rate was 18% (253 patients), while the predicted mortality rate was 16.9%. The area under the ROC curve was 0.889 (95% CI: 0.867-0.911). Patients with blunt trauma (n=1305) had an area under the ROC curve of 0.887 (95% CI: 0.864-0.910), and those with penetrating trauma (n=100) presented an area under the curve of 0.919 (95% CI: 0.859-0.979). In the global sample, the HL test yielded a value of 25.38 (p=0.001): 27.35 (p<0.0001) in blunt trauma and 5.91 (p=0.658) in penetrating trauma. TRISS methodology underestimated mortality in patients with low predicted mortality and overestimated mortality in patients with high predicted mortality.
  
  
  CONCLUSIONS
  TRISS methodology in the evaluation of severe trauma in Spanish ICUs showed good discrimination, with inadequate calibration - particularly in blunt trauma.
authors.affiliation: Trauma and Emergencies ICU, Department of Intensive Care Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Chico-Fernández
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain. Electronic address: juanantonio.llompart@ssib.es.
authors.forename: J A
authors.initials: JA
authors.lastname: Llompart-Pou
authors.affiliation: Department of Intensive Care Medicine, Hospital Virgen de la Salud, Toledo, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Casado
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitario de Donostia, San Sebastián, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Alberdi-Odriozola
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Guerrero-López
authors.affiliation: Department of Intensive Care Medicine, Complejo Hospitalario de Torrecárdenas, Almería, Spain.
authors.forename: M D
authors.initials: MD
authors.lastname: Mayor-García
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
authors.forename: J J
authors.initials: JJ
authors.lastname: Egea-Guerrero
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitario Carlos Haya, Málaga, Spain.
authors.forename: J F
authors.initials: JF
authors.lastname: Fernández-Ortega
authors.affiliation: Department of Intensive Care Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Bueno-González
authors.affiliation: Department of Intensive Care Medicine, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
authors.forename: J
authors.initials: J
authors.lastname: González-Robledo
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Servià-Goixart
authors.affiliation: Department of Intensive Care Medicine, Complejo Hospitalario de Pamplona, Navarra, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Roldán-Ramírez
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: M Á
authors.initials: MÁ
authors.lastname: Ballesteros-Sanz
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Tejerina-Alvarez
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain.
authors.forename: F I
authors.initials: FI
authors.lastname: Pino-Sánchez
authors.affiliation: Department of Intensive Care Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Homar-Ramírez
mesh_terms: D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012042:Registries; D013030:Spain; D015599:Trauma Severity Indices
keywords: Intensive Care Unit; Mortality prediction; Predicción de mortalidad; Registros de trauma; TRISS; Trauma; Trauma registry; Unidad de Cuidados Intensivos