西班牙纳瓦拉地区急救服务救治的严重创伤患者的死亡率：新预测模型的验证及与修订版创伤严重程度分类评分 II 的比较。
Mortality in severe trauma patients attended by emergency services in Navarre, Spain: validation of a new prediction model and comparison with the Revised Injury Severity Classification Score II.
机构信息
Servicio de Urgencias del Complejo Hospitalario de Navarra, Servicio Navarro de Salud-Osasunbidea, Pamplona, España.
Institute for Research in Operative Medicine (IFOM), Universidad de Witten/Herdecke, Alemania.
出版信息
Emergencias. 2018;30(2):98-104.
OBJECTIVES
To validate the Mortality Prediction Model of Navarre (MPMN) to predict death after severe trauma and compare it to the Revised Injury Severity Classification Score II (RISCII).
MATERIAL AND METHODS
Retrospective analysis of a cohort of severe trauma patients (New Injury Severity Score >15) who were attended by emergency services in the Spanish autonomous community of Navarre between 2013 and 2015. The outcome variable was 30-day all-cause mortality. Risk was calculated with the MPMN and the RISCII. The performance of each model was assessed with the area under the receiver operating characteristic (ROC) curve and precision with respect to observed mortality. Calibration was assessed with the Hosmer-Lemeshow test.
RESULTS
We included 516 patients. The mean (SD) age was 56 (23) years, and 363 (70%) were males. Ninety patients (17.4%) died within 30 days. The 30-day mortality rates predicted by the MPMN and RISCII were 16.4% and 15.4%, respectively. The areas under the ROC curves were 0.925 (95% CI, 0.902-0.952) for the MPMN and 0.941 (95% CI, 0.921-0.962) for the RISCII (P=0.269, DeLong test). Calibration statistics were 13.6 (P=.09) for the MPMN and 8.9 (P=.35) for the RISCII.
CONCLUSION
Both the MPMN and the RISCII show good ability to discriminate risk and predict 30-day all-cause mortality in severe trauma patients.
目的
验证用于预测严重创伤后死亡的纳瓦雷死亡率预测模型（MPMN），并将其与修订后的损伤严重程度分类评分 II（RISCII）进行比较。
材料和方法
回顾性分析了 2013 年至 2015 年期间在西班牙纳瓦拉自治区接受急诊服务的严重创伤患者（新损伤严重程度评分>15）队列。结局变量为 30 天全因死亡率。使用 MPMN 和 RISCII 计算风险。通过接收者操作特征曲线（ROC）下面积和观察死亡率的精度来评估每个模型的性能。使用 Hosmer-Lemeshow 检验评估校准。
结果
共纳入 516 例患者。平均（SD）年龄为 56（23）岁，男性 363 例（70%）。90 例（17.4%）患者在 30 天内死亡。MPMN 和 RISCII 预测的 30 天死亡率分别为 16.4%和 15.4%。MPMN 的 ROC 曲线下面积为 0.925（95%CI，0.902-0.952），RISCII 的 ROC 曲线下面积为 0.941（95%CI，0.921-0.962）（P=0.269，DeLong 检验）。MPMN 的校准统计量为 13.6（P=.09），RISCII 的校准统计量为 8.9（P=.35）。
结论
MPMN 和 RISCII 均能较好地鉴别风险，预测严重创伤患者 30 天全因死亡率。
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