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External validation of the Norwegian survival prediction model in trauma after major trauma in Southern Finland.

作者信息

Raj R, Brinck T, Skrifvars M B, Handolin L

机构信息

Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Töölö Trauma Unit, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

出版信息

Acta Anaesthesiol Scand. 2016 Jan;60(1):48-58. doi: 10.1111/aas.12592. Epub 2015 Aug 6.


DOI:10.1111/aas.12592
PMID:26251159
Abstract

BACKGROUND: The Norwegian Survival Prediction Model in Trauma (NORMIT) is a newly developed outcome prediction model for patients with trauma. We aimed to compare the novel NORMIT to the more commonly used Trauma and Injury Severity Score (TRISS) in Finnish trauma patients. METHODS: We performed a retrospective open-cohort study, using the trauma registry of Helsinki university hospital's trauma unit, including severely injured patients (new injury severity score > 15) admitted from 2007 to 2011. We used 30-day in-hospital mortality as the primary outcome, and discharge functional outcome as a secondary outcome of interest. Model performance was evaluated by comparing discrimination (by area under the receiver operating characteristic curve [AUC]), using a re-sample bootstrap technique, and by assessing calibration (GiViTI belt). RESULTS: We identified 1111 patients fulfilling the study inclusion criteria. Overall mortality was 13% (n = 147). NORMIT showed slightly better discrimination for mortality prediction (AUC = 0.83, 95% confidence interval [CI] = 0.80-0.86 vs. AUC = 0.79, 95% CI = 0.75-0.83, P = 0.004) and functional outcome prediction (AUC = 0.78, 95% CI = 0.76-0.82 vs. AUC = 0.75, 95% CI = 0.72-0.78, P < 0.001) than TRISS. Calibration testing revealed poor calibration for both NORMIT and TRISS (P < 0.001), by giving too pessimistic predictions (predicted survival significantly lower than actual survival). CONCLUSION: NORMIT and TRISS showed good discrimination, but poor calibration, in this mixed cohort of severely injured trauma patients from Southern Finland. We found NORMIT to be a feasible alternative to TRISS for trauma patient outcome prediction, but trauma prediction models with improved calibration are needed.

摘要

相似文献

[1]
External validation of the Norwegian survival prediction model in trauma after major trauma in Southern Finland.

Acta Anaesthesiol Scand. 2016-1

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Development and Validation of a Korean Trauma and Injury Severity Score (K-TRISS) Model for Predicting Trauma Outcomes.

J Korean Med Sci. 2025-6-30

[2]
Assessing optimal methods for transferring machine learning models to low-volume and imbalanced clinical datasets: experiences from predicting outcomes of Danish trauma patients.

Front Digit Health. 2023-11-2

[3]
Risk-adjusted mortality in severely injured adult trauma patients in Sweden.

BJS Open. 2022-3-8

[4]
Validating performance of TRISS, TARN and NORMIT survival prediction models in a Norwegian trauma population.

Acta Anaesthesiol Scand. 2018-2

[5]
Comparison of risk-adjusted survival in two Scandinavian Level-I trauma centres.

Scand J Trauma Resusc Emerg Med. 2016-5-10

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