Diagnostic Accuracy of a Trauma Risk Assessment Tool Among Geriatric Patients With Crash Injuries.

Area of Science:

• Trauma Surgery
• Geriatric Medicine
• Clinical Risk Stratification

Background:

• Older adults (55+) are vulnerable to adverse outcomes after trauma.
• Effective risk stratification tools are needed for this demographic.
• The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a potential tool.

Purpose of the Study:

• To evaluate the accuracy of the STTGMA in predicting 30-day mortality.
• To assess the STTGMA's ability to predict unfavorable clinical trajectories in trauma patients.
• To validate the STTGMA's performance in a real-world cohort.

Main Methods:

• Retrospective cohort study of 912 adult trauma patients (age ≥ 55).
• Data split into training (70%) and testing (30%) sets for validation.
• Receiver operating curve analysis used to assess predictive accuracy of STTGMA high-energy score (STTGMAHE).

Main Results:

• STTGMAHE showed 82% accuracy in predicting 30-day mortality in the training set and 96% in the test set.
• STTGMA risk categories significantly stratified ICU admissions, complications, and length of stay.
• Increased risk categories correlated with higher odds of adverse outcomes (dose-response).

Conclusions:

• The STTGMAHE is highly accurate in identifying older trauma patients at risk of mortality.
• The STTGMA effectively stratifies risk for unfavorable clinical trajectories in this population.
• This tool can aid in managing geriatric and middle-aged trauma patients.