Development and validation of a new simplified anatomic trauma mortality score

Jih Huei Tan, Yuzaidi Mohamad, Rizal Imran Alwi, Chor Lip Henry Tan, Affirul Chairil Ariffin, Razman Jarmin

Research output: Contribution to journalArticle

Abstract

Background: Most trauma mortality prediction scores are complex in nature. GAP (Glasgow Coma Scale, Age, Systolic blood pressure) and mGAP (mechanism, Glasgow Coma Scale, Age, Systolic blood pressure) scores are relatively simple scoring tools. However, these scores were not validated in low and middle income countries including Malaysia and its accuracies are influenced by the fluctuating physiologic parameters. This study aims to develop a relevant simplified anatomic trauma scoring system for the local trauma patients in Malaysia. Method: A total of 3825 trauma patients from 2011 to 2016 were extracted from the Hospital Sultanah Aminah Trauma Surgery Registry. Patients were split into a development sample (n = 2683) and a validation sample (n = 1142). Univariate analysis is applied to identify significant anatomic predictors. These predictors were further analyzed using multivariable logistic regression to develop the new score and compared to existing score systems. The quality of prediction was determined regarding discrimination using sensitivity, specificity and receiver operating characteristic [ROC] curve. Results: Existing simplified score systems (GAP & mGAP) revealed areas under the ROC curve of 0.825 and 0.806. The newly developed HeCLLiP (Head, cervical spine, lung, liver, pelvic fracture) score combines only five anatomic components: injury involving head, cervical spine, lung, liver and pelvic bone. The probabilities of mortality can be estimated by charting the total score points onto a graph chart or using the cut-off value of (>2) with a sensitivity of 79.2 and specificity of 70.6% on the validation dataset. The HeCLLiP score achieved comparable values of 0.802 for the area under the ROC curve in validation samples. Conclusion: HeCLLiP Score is a simplified anatomic score suited to the local Malaysian population with a good predictive ability for trauma mortality.

Original languageEnglish
JournalInjury
DOIs
Publication statusAccepted/In press - 1 Jan 2019

Fingerprint

Mortality
Wounds and Injuries
Spine
ROC Curve
Blood Pressure
Lung
Glasgow Coma Scale
Liver
Malaysia
Head
Pelvic Bones
Sensitivity and Specificity
Craniocerebral Trauma
Registries
Logistic Models
Population

Keywords

  • Mortality
  • Prognosis
  • Trauma
  • Trauma severity indices

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

Cite this

Tan, J. H., Mohamad, Y., Imran Alwi, R., Henry Tan, C. L., Chairil Ariffin, A., & Jarmin, R. (Accepted/In press). Development and validation of a new simplified anatomic trauma mortality score. Injury. https://doi.org/10.1016/j.injury.2019.01.027

Development and validation of a new simplified anatomic trauma mortality score. / Tan, Jih Huei; Mohamad, Yuzaidi; Imran Alwi, Rizal; Henry Tan, Chor Lip; Chairil Ariffin, Affirul; Jarmin, Razman.

In: Injury, 01.01.2019.

Research output: Contribution to journalArticle

Tan, Jih Huei ; Mohamad, Yuzaidi ; Imran Alwi, Rizal ; Henry Tan, Chor Lip ; Chairil Ariffin, Affirul ; Jarmin, Razman. / Development and validation of a new simplified anatomic trauma mortality score. In: Injury. 2019.
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