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Severity indexes of blunt trauma victims in intensive therapy: prediction capacity for mortality
Kézia Porto Lima1,2, Lilia de Souza Nogueira1, Genesis Barbosa1,3
1Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem na Saúde do Adulto, São Paulo, SP, Brasil.
Objective:
To identify the predictive capacity for mortality of the indexes Revised Trauma Score, Rapid Emergency Medicine Score, modified Rapid Emergency Medicine Score, and Simplified Acute Physiology Score III in blunt trauma victims hospitalized in an intensive care unit and compare their performance.
Method:
Retrospective cohort of patients with blunt trauma in an intensive care unit from medical records. Receiver Operating Characteristic and a 95% confidence interval of the area under the curve were analyzed to compare results.
Results:
Out of 165 analyzed patients, 66.7% have received surgical treatment. The mortality in the intensive care unit and in the hospital was 17.6% and 20.6%, respectively. For the mortality in the intensive care unit, the area under the curve varied from 0.672 to 0.738; however, better results have been observed in surgical patients (0.747 to 0.811). Similar results have been observed for in-hospital mortality. In all analyses, the areas under the curve of the indexes presented no significant difference.
Conclusion:
The accuracy of the severity indexes was moderate, with an improved performance when applied to surgical patients. The four indexes presented a similar prediction for the analyzed outcomes.
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