Scherer Julian, Kalbas Yannik, Ziegenhain Franziska, Neuhaus Valentin, Lefering Rolf, Teuben Michel, Sprengel Kai, Pape Hans-Christoph, Jensen Kai Oliver
Department of Traumatology, University Hospital of Zürich, 8091 Zürich, Switzerland.
Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, 58453 Cologne, Germany.
J Clin Med. 2021 Mar 25;10(7):1362. doi: 10.3390/jcm10071362.
Feasible and predictive scoring systems for severely injured geriatric patients are lacking. Therefore, the aim of this study was to develop a scoring system for the prediction of in-hospital mortality in severely injured geriatric trauma patients. The TraumaRegister DGU (TR-DGU) was utilized. European geriatric patients (≥65 years) admitted between 2008 and 2017 were included. Relevant patient variables were implemented in the GERtality score. By conducting a receiver operating characteristic (ROC) analysis, a comparison with the Geriatric Trauma Outcome Score (GTOS) and the Revised Injury Severity Classification II (RISC-II) Score was performed. A total of 58,055 geriatric trauma patients (mean age: 77 years) were included. Univariable analysis led to the following variables: age ≥ 80 years, need for packed red blood cells (PRBC) transfusion prior to intensive care unit (ICU), American Society of Anesthesiologists (ASA) score ≥ 3, Glasgow Coma Scale (GCS) ≤ 13, Abbreviated Injury Scale (AIS) in any body region ≥ 4. The maximum GERtality score was 5 points. A mortality rate of 72.4% was calculated in patients with the maximum GERtality score. Mortality rates of 65.1 and 47.5% were encountered in patients with GERtality scores of 4 and 3 points, respectively. The area under the curve (AUC) of the novel GERtality score was 0.803 (GTOS: 0.784; RISC-II: 0.879). The novel GERtality score is a simple and feasible score that enables an adequate prediction of the probability of mortality in polytraumatized geriatric patients by using only five specific parameters.
目前尚缺乏适用于重伤老年患者的可行且具有预测性的评分系统。因此，本研究的目的是开发一种用于预测重伤老年创伤患者院内死亡率的评分系统。使用了创伤登记数据库DGU（TR-DGU）。纳入了2008年至2017年间收治的欧洲老年患者（≥65岁）。相关患者变量被纳入GERtality评分。通过进行受试者工作特征（ROC）分析，与老年创伤结局评分（GTOS）和修订的损伤严重程度分类II（RISC-II）评分进行了比较。共纳入58,055例老年创伤患者（平均年龄：77岁）。单变量分析得出以下变量：年龄≥80岁、重症监护病房（ICU）入院前需要输注浓缩红细胞（PRBC）、美国麻醉医师协会（ASA）评分≥3、格拉斯哥昏迷量表（GCS）≤13、任何身体部位的简明损伤量表（AIS）≥4。GERtality评分最高为5分。GERtality评分最高的患者计算出的死亡率为72.4%。GERtality评分为4分和3分的患者死亡率分别为65.1%和47.5%。新型GERtality评分的曲线下面积（AUC）为0.803（GTOS：0.784；RISC-II：0.879）。新型GERtality评分是一个简单可行的评分，仅使用五个特定参数就能充分预测多发伤老年患者的死亡概率。
