Comparison of two prognostic models in trauma outcome

The British Journal of Surgery
Alan CookDavid Hosmer

Abstract

The Trauma Audit and Research Network (TARN) in the UK publicly reports hospital performance in the management of trauma. The TARN risk adjustment model uses a fractional polynomial transformation of the Injury Severity Score (ISS) as the measure of anatomical injury severity. The Trauma Mortality Prediction Model (TMPM) is an alternative to ISS; this study compared the anatomical injury components of the TARN model with the TMPM. Data from the National Trauma Data Bank for 2011-2015 were analysed. Probability of death was estimated for the TARN fractional polynomial transformation of ISS and compared with the TMPM. The coefficients for each model were estimated using 80 per cent of the data set, selected randomly. The remaining 20 per cent of the data were used for model validation. TMPM and TARN were compared using calibration curves, measures of discrimination (area under receiver operating characteristic curves; AUROC), proximity to the true model (Akaike information criterion; AIC) and goodness of model fit (Hosmer-Lemeshow test). Some 438 058 patient records were analysed. TMPM demonstrated preferable AUROC (0·882 for TMPM versus 0·845 for TARN), AIC (18 204 versus 21 163) and better fit to the data (32·4 versus 153·0) co...Continue Reading

References

May 1, 1990·The Journal of Trauma·H R ChampionS Schwaitzberg
Sep 1, 1981·Critical Care Medicine·H R ChampionW J Fouty
Mar 1, 1980·The Journal of Trauma·H R ChampionR H Prall
Sep 30, 2004·The Journal of Trauma·Patrick D KilgoTurner M Osler
Sep 13, 2006·The Journal of Trauma·Omar BouamraFiona Lecky
Jun 4, 2008·Annals of Surgery·Turner OslerAndrew Dick
May 29, 2009·Annals of Surgery·Laurent G GlanceAndrew W Dick
Feb 16, 2010·The Journal of Trauma·Mark R HemmilaJohn J Fildes
Jun 15, 2012·The Journal of Trauma and Acute Care Surgery·Adil H HaiderEric B Schneider
Dec 26, 2013·The Journal of Trauma and Acute Care Surgery·Alan CookTurner Osler
Oct 24, 2015·Emergency Medicine Journal : EMJ·Omar BouamraFiona Lecky

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Citations

Jan 9, 2020·The Journal of Trauma and Acute Care Surgery·Jill Lynn JakubusMark R Hemmila
Apr 24, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Rolf LeferingOmar Bouamra

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