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Prehospital Index provides prognosis for hospitalized patients with acute trauma
Hai-Lin Ruan1, Wen-Han Ge2, Jian-Ping Chen1
1Department of Emergency, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi.
Insights
The Prehospital Index (PHI) effectively predicts prognosis in acute trauma patients, outperforming the Injury Severity Score (ISS). This simple, dynamic tool aids in identifying critically ill trauma patients.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Clinical Prognostics
Background:
- Accurate prognostic assessment is crucial for managing acute trauma patients.
- Existing scoring systems like the Injury Severity Score (ISS) have limitations in prehospital settings.
Purpose of the Study:
- To evaluate the prognostic value of the Prehospital Index (PHI) in hospitalized acute trauma patients.
- To compare the predictive performance of PHI against the ISS.
Main Methods:
- A retrospective analysis of 1,802 hospitalized acute trauma patients.
- Calculation of PHI and ISS scores.
- Use of Receiver-Operator Characteristic (ROC) curves to compare PHI and ISS predictive accuracy.
Main Results:
- PHI demonstrated a higher Area Under the ROC Curve (0.871) compared to ISS (0.792).
- PHI showed superior sensitivity (P=0.008) in predicting critical illness risk.
- Optimal cutoff points were identified as PHI ≥4 and ISS ≥22.
Conclusions:
- The PHI is a valuable and superior prognostic tool for hospitalized acute trauma patients.
- PHI offers advantages in simplicity, timeliness, reliability, and suitability for dynamic evaluation.
- PHI can effectively screen for critically ill trauma patients.
Objective:
To evaluate the prognostic value of the Prehospital Index (PHI) for hospitalized patients with acute trauma.
Materials And Methods:
PHI score and the Injury Severity Score (ISS) were determined in 1,802 hospitalized patients with acute trauma. Receiver-operator characteristic (ROC) curves were used to compare the PHI and ISS in subgroups, and corresponding prediction indicators were calculated.
Results:
There were significant differences in PHI score and ISS between the survival group and the death group (Z=2.674, P=0.007). The area under the ROC curve was 0.871 (95% CI 0.855-0.886) for PHI score and 0.792 (95% CI 0.773-0.811) for ISS. Optimal cutoff points to determine the risk of critical illness were PHI ≥4 and ISS ≥22. The sensitivity of the PHI was superior to the ISS (χ2=6.975, P=0.008), but the specificity and the accuracy of the PHI and ISS showed no significant difference (P>0.05).
Conclusion:
The PHI is valuable in prognostic prediction of hospitalized patients with acute trauma, and it is superior to the ISS. The PHI has such advantages as being simple in operation, easy to learn, capable of reflecting conditions timely and reliably, and suitable for dynamic evaluation and screening for critical patients with trauma.
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