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Comparison of National Surgical Quality Improvement Program Surgical Risk Calculator and Trauma and Injury Severity Score Risk Assessment Tools in Predicting Outcomes in High-Risk Operative Trauma Patients.
Santos, Jeffrey; Kuza, Catherine M; Luo, Xi; Ogunnaike, Babatunde; Ahmed, M Iqbal; Melikman, Emily; Moon, Tiffany; Shoultz, Thomas; Feeler, Anne; Dudaryk, Roman; Navas, Jose; Vasileiou, Georgia; Yeh, D Dante; Matsushima, Kazuhide; Forestiere, Matthew; Lian, Tiffany; Grigorian, Areg; Ricks-Oddie, Joni; Nahmias, Jeffry.
Afiliação
  • Santos J; Division of Trauma, Burns, Critical Care & Acute Care Surgery, Department of Surgery, University of California, Irvine, Orange, CA, USA.
  • Kuza CM; Department of Anesthesiology, University of Southern California, Los Angeles, CA, USA.
  • Luo X; Department of Anesthesiology, University of Texas Southwestern, Dallas, TX, USA.
  • Ogunnaike B; Department of Anesthesiology, University of Texas Southwestern, Dallas, TX, USA.
  • Ahmed MI; Department of Anesthesiology, University of Texas Southwestern, Dallas, TX, USA.
  • Melikman E; Department of Anesthesiology, University of Texas Southwestern, Dallas, TX, USA.
  • Moon T; Department of Anesthesiology, University of Texas Southwestern, Dallas, TX, USA.
  • Shoultz T; Division of Burns, Trauma and Critical Care, University of Texas Southwestern, Dallas, TX, USA.
  • Feeler A; Division of Burns, Trauma and Critical Care, University of Texas Southwestern, Dallas, TX, USA.
  • Dudaryk R; Department of Anesthesiology and Pain Management, University of Miami, Miami, FL, USA.
  • Navas J; Department of Anesthesiology and Pain Management, University of Miami, Miami, FL, USA.
  • Vasileiou G; Department of Surgery, University of Miami, Miami, FL, USA.
  • Yeh DD; Department of Surgery, University of Miami, Miami, FL, USA.
  • Matsushima K; Department of Surgery, University of Southern California, Los Angeles, CA, USA.
  • Forestiere M; Department of Surgery, University of Southern California, Los Angeles, CA, USA.
  • Lian T; Department of Surgery, University of Southern California, Los Angeles, CA, USA.
  • Grigorian A; Division of Trauma, Burns, Critical Care & Acute Care Surgery, Department of Surgery, University of California, Irvine, Orange, CA, USA.
  • Ricks-Oddie J; Institute for Clinical and Translation Sciences and Center for Statistical Consulting, University of California, Irvine, Orange, CA, USA.
  • Nahmias J; Division of Trauma, Burns, Critical Care & Acute Care Surgery, Department of Surgery, University of California, Irvine, Orange, CA, USA.
Am Surg ; 89(10): 4038-4044, 2023 Oct.
Article em En | MEDLINE | ID: mdl-37173283
ABSTRACT

BACKGROUND:

The Trauma and Injury Severity Score (TRISS) uses anatomic/physiologic variables to predict outcomes. The National Surgical Quality Improvement Program Surgical Risk Calculator (NSQIP-SRC) includes functional status and comorbidities. It is unclear which of these tools is superior for high-risk trauma patients (American Society of Anesthesiologists Physical Status (ASA-PS) class IV or V). This study compares risk prediction of TRISS and NSQIP-SRC for mortality, length of stay (LOS), and complications for high-risk operative trauma patients.

METHODS:

This is a prospective study of high-risk (ASA-PS IV or V) trauma patients (≥18 years-old) undergoing surgery at 4 trauma centers. We compared TRISS vs NSQIP-SRC vs NSQIP-SRC + TRISS for ability to predict mortality, LOS, and complications using linear, logistic, and negative binomial regression.

RESULTS:

Of 284 patients, 48 (16.9%) died. The median LOS was 16 days and number of complications was 1. TRISS + NSQIP-SRC best predicted mortality (AUROC .877 vs .723 vs .843, P = .0018) and number of complications (pseudo-R2/median error (ME) 5.26%/1.15 vs 3.39%/1.33 vs 2.07%/1.41, P < .001) compared to NSQIP-SRC or TRISS, but there was no difference between TRISS + NSQIP-SRC and NSQIP-SRC with LOS prediction (P = .43).

DISCUSSION:

For high-risk operative trauma patients, TRISS + NSQIP-SRC performed better at predicting mortality and number of complications compared to NSQIP-SRC or TRISS alone but similar to NSQIP-SRC alone for LOS. Thus, future risk prediction and comparisons across trauma centers for high-risk operative trauma patients should include a combination of anatomic/physiologic data, comorbidities, and functional status.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Melhoria de Qualidade / Ferida Cirúrgica Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Melhoria de Qualidade / Ferida Cirúrgica Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article