A survival prediction logistic regression models for blunt trauma victims in Japan

Abstract

AimThis research aimed to propose a logistic regression model for Japanese blunt trauma victims.MethodsWe tested whether the logistic regression model previously created from data registered in the Japan Trauma Data Bank between 2005 and 2008 is still valid for the data from the same data bank between 2009 and 2013. Additionally, we analyzed whether the model would be highly accurate even when its coefficients were rounded off to two decimal places.ResultsThe model was proved to be highly accurate (94.56%) in the recent data (2009–2013). We also showed that the model remains valid without respiratory rate data and the simplified model would maintain high accuracy.ConclusionWe propose the equation of survival prediction of blunt trauma victims in Japan to be Ps = 1/(1+e−b), where b = −0.76 + 1.03 × Revised Trauma Score − 0.07 × Injury Severity Score − 0.04 × age.

Validation of Age-specific Survival Prediction in Pediatric Patients With Blunt Trauma Using Trauma and Injury Severity Score Methodology: A Ten-year Nationwide Observational Study

“…In the subclass analysis by TRISS Ps-interval groups, the accuracy of the TRISS model for patients with Ps ≤ 0.95 did not have high performance and the observed-to expected mortality ratio in pediatric patients with Ps ≤ 0.25 was 2.15. Previous studies also suggested similar results, which are as follows: TRISS had lower performance in Japanese blunt trauma patients with Ps < 0.9 than those with Ps ≥ 0.9 [9] and TRISS underestimates survival for pediatric trauma patients with TRISS Ps ≤ 91% [10]. Previous studies suggested that the decreasing trend of in-hospital mortality among trauma patients decreased in recent years would lead the TRISS model to be out of calibration [8,11].…”

“…Previous studies based on a Japanese cohort, including children registered in the JTDB during 2005-2008 and 2009-2013 proved that the AUC of TRISS was 0.962 and 0.948 [9,17]. These Japanese studies focused on paediatric patients with blunt trauma and demonstrated that the TRISS had a high performance only for Japanese pediatric patients, as in a previous study [9,17]. Although it is di cult to compare the results between previous studies and this study because of the different periods when the studies were conducted, our results suggest that the TRISS model may be appropriate for Japanese pediatric patients with blunt trauma.…”

“…Because the accuracy of the TRISS model may re ect the in uence of demographic differences in trauma such as the trauma care system or the population structure between the sample area and the USA, wherein the TRISS method was developed, local database-derived coe cients may further enhance the predictive performance of TRISS [12,13,16,17]. Previous studies based on a Japanese cohort, including children registered in the JTDB during 2005-2008 and 2009-2013 proved that the AUC of TRISS was 0.962 and 0.948 [9,17]. These Japanese studies focused on paediatric patients with blunt trauma and demonstrated that the TRISS had a high performance only for Japanese pediatric patients, as in a previous study [9,17].…”

“…A Previous study indicated that the evaluation of consciousness using GCS in children younger than 5 years is challenging owing to their limited verbal communications and motor responses; therefore, simpli ed evaluation tools such as AVPU score (A, Alert; V, responsive to Verbal stimulus; P, responsive to Painful stimulus; U, Unresponsive) instead of GCS, suggested to facilitate evaluation and improvement of data quality in younger children [20]. Furthermore, a previous study showed that RR data, which are missing in most cases in the JTDB in the Japan JTDB dataset, might be less needed for the calculation of TRISS Ps in accuracy [9,17,21]. It may be necessary to construct the modi ed TRISS model or new prediction model with higher accuracy and suitable for the Japanese situation based on validation of the Japanese dataset.…”

Validation of age-specific survival prediction in pediatric patients with blunt trauma using trauma and injury severity score methodology: a ten-year Nationwide observational study

“…The accuracy of the TRISS method, nevertheless, has various challenges in terms of the investigated area, time, and age. First, previous studies suggested that the TRISS has a low accuracy for survival prediction in patients with higher severity of the injury or younger pediatric patients [ 9 , 10 ]. Second, previous studies suggested that there is a trend to improve the observed-to-expected mortality ratio in major trauma patients, and therefore, new coefficients should be calculated according to these improvements in trauma care for the TRISS to maintain the accuracy for survival prediction [ 9 , 11 ].…”