Comparison of the predictive performance of the BIG, TRISS, and PS09 score in anadult trauma population derived from multiple international trauma registries

Thomas Brockamp, Marc Maegele, Christine Gaarder, J. C. Goslings, Mitchell J. Cohen, Rolf Lefering, Pieter Joosse, Paal A. Naess, Nils O. Skaga, Tahnee Groat, Simon Eaglestone, Matthew A. Borgman, Philip C. Spinella, Martin Schreiber, Karim Brohi

    Research output: Contribution to journalArticle

    15 Citations (Scopus)

    Abstract

    Background: The BIG score (Admission base deficit (B), International normalized ratio (I), andGlasgow Coma Scale (G)) has been shown to predict mortality on admission inpediatric trauma patients. The objective of this study was to assess itsperformance in predicting mortality in an adult trauma population, and to compareit with the existing Trauma and Injury Severity Score (TRISS) and probability ofsurvival (PS09) score.Materials and methods: A retrospective analysis using data collected between 2005 and 2010 from seventrauma centers and registries in Europe and the United States of America wasperformed. We compared the BIG score with TRISS and PS09 scores in a population ofblunt and penetrating trauma patients. We then assessed the discrimination abilityof all scores via receiver operating characteristic (ROC) curves and compared theexpected mortality rate (precision) of all scores with the observed mortalityrate.Results: In total, 12,206 datasets were retrieved to validate the BIG score. The mean ISSwas 15 ± 11, and the mean 30-day mortality rate was 4.8%. With an AUROC of0.892 (95% confidence interval (CI): 0.879 to 0.906), the BIG score performed wellin an adult population. TRISS had an area under ROC (AUROC) of 0.922 (0.913 to0.932) and the PS09 score of 0.825 (0.915 to 0.934). On a penetrating-traumapopulation, the BIG score had an AUROC result of 0.920 (0.898 to 0.942) comparedwith the PS09 score (AUROC of 0.921; 0.902 to 0.939) and TRISS (0.929; 0.912 to0.947).Conclusions: The BIG score is a good predictor of mortality in the adult trauma population. Itperformed well compared with TRISS and the PS09 score, although it hassignificantly less discriminative ability. In a penetrating-trauma population, theBIG score performed better than in a population with blunt trauma. The BIG scorehas the advantage of being available shortly after admission and may be used topredict clinical prognosis or as a research tool to risk stratify trauma patientsinto clinical trials.

    Original languageEnglish (US)
    Article numberR134
    JournalCritical Care
    Volume17
    Issue number4
    DOIs
    StatePublished - Jul 11 2013

    Fingerprint

    Injury Severity Score
    Multiple Trauma
    Registries
    Wounds and Injuries
    Population
    Mortality
    ROC Curve
    International Normalized Ratio
    Coma

    ASJC Scopus subject areas

    • Critical Care and Intensive Care Medicine
    • Medicine(all)

    Cite this

    Comparison of the predictive performance of the BIG, TRISS, and PS09 score in anadult trauma population derived from multiple international trauma registries. / Brockamp, Thomas; Maegele, Marc; Gaarder, Christine; Goslings, J. C.; Cohen, Mitchell J.; Lefering, Rolf; Joosse, Pieter; Naess, Paal A.; Skaga, Nils O.; Groat, Tahnee; Eaglestone, Simon; Borgman, Matthew A.; Spinella, Philip C.; Schreiber, Martin; Brohi, Karim.

    In: Critical Care, Vol. 17, No. 4, R134, 11.07.2013.

    Research output: Contribution to journalArticle

    Brockamp, T, Maegele, M, Gaarder, C, Goslings, JC, Cohen, MJ, Lefering, R, Joosse, P, Naess, PA, Skaga, NO, Groat, T, Eaglestone, S, Borgman, MA, Spinella, PC, Schreiber, M & Brohi, K 2013, 'Comparison of the predictive performance of the BIG, TRISS, and PS09 score in anadult trauma population derived from multiple international trauma registries', Critical Care, vol. 17, no. 4, R134. https://doi.org/10.1186/cc12813
    Brockamp, Thomas ; Maegele, Marc ; Gaarder, Christine ; Goslings, J. C. ; Cohen, Mitchell J. ; Lefering, Rolf ; Joosse, Pieter ; Naess, Paal A. ; Skaga, Nils O. ; Groat, Tahnee ; Eaglestone, Simon ; Borgman, Matthew A. ; Spinella, Philip C. ; Schreiber, Martin ; Brohi, Karim. / Comparison of the predictive performance of the BIG, TRISS, and PS09 score in anadult trauma population derived from multiple international trauma registries. In: Critical Care. 2013 ; Vol. 17, No. 4.
    @article{500acedc14cd41f1bb3bc0ae746f0fd2,
    title = "Comparison of the predictive performance of the BIG, TRISS, and PS09 score in anadult trauma population derived from multiple international trauma registries",
    abstract = "Background: The BIG score (Admission base deficit (B), International normalized ratio (I), andGlasgow Coma Scale (G)) has been shown to predict mortality on admission inpediatric trauma patients. The objective of this study was to assess itsperformance in predicting mortality in an adult trauma population, and to compareit with the existing Trauma and Injury Severity Score (TRISS) and probability ofsurvival (PS09) score.Materials and methods: A retrospective analysis using data collected between 2005 and 2010 from seventrauma centers and registries in Europe and the United States of America wasperformed. We compared the BIG score with TRISS and PS09 scores in a population ofblunt and penetrating trauma patients. We then assessed the discrimination abilityof all scores via receiver operating characteristic (ROC) curves and compared theexpected mortality rate (precision) of all scores with the observed mortalityrate.Results: In total, 12,206 datasets were retrieved to validate the BIG score. The mean ISSwas 15 ± 11, and the mean 30-day mortality rate was 4.8{\%}. With an AUROC of0.892 (95{\%} confidence interval (CI): 0.879 to 0.906), the BIG score performed wellin an adult population. TRISS had an area under ROC (AUROC) of 0.922 (0.913 to0.932) and the PS09 score of 0.825 (0.915 to 0.934). On a penetrating-traumapopulation, the BIG score had an AUROC result of 0.920 (0.898 to 0.942) comparedwith the PS09 score (AUROC of 0.921; 0.902 to 0.939) and TRISS (0.929; 0.912 to0.947).Conclusions: The BIG score is a good predictor of mortality in the adult trauma population. Itperformed well compared with TRISS and the PS09 score, although it hassignificantly less discriminative ability. In a penetrating-trauma population, theBIG score performed better than in a population with blunt trauma. The BIG scorehas the advantage of being available shortly after admission and may be used topredict clinical prognosis or as a research tool to risk stratify trauma patientsinto clinical trials.",
    author = "Thomas Brockamp and Marc Maegele and Christine Gaarder and Goslings, {J. C.} and Cohen, {Mitchell J.} and Rolf Lefering and Pieter Joosse and Naess, {Paal A.} and Skaga, {Nils O.} and Tahnee Groat and Simon Eaglestone and Borgman, {Matthew A.} and Spinella, {Philip C.} and Martin Schreiber and Karim Brohi",
    year = "2013",
    month = "7",
    day = "11",
    doi = "10.1186/cc12813",
    language = "English (US)",
    volume = "17",
    journal = "Critical Care",
    issn = "1364-8535",
    publisher = "BioMed Central Ltd.",
    number = "4",

    }

    TY - JOUR

    T1 - Comparison of the predictive performance of the BIG, TRISS, and PS09 score in anadult trauma population derived from multiple international trauma registries

    AU - Brockamp, Thomas

    AU - Maegele, Marc

    AU - Gaarder, Christine

    AU - Goslings, J. C.

    AU - Cohen, Mitchell J.

    AU - Lefering, Rolf

    AU - Joosse, Pieter

    AU - Naess, Paal A.

    AU - Skaga, Nils O.

    AU - Groat, Tahnee

    AU - Eaglestone, Simon

    AU - Borgman, Matthew A.

    AU - Spinella, Philip C.

    AU - Schreiber, Martin

    AU - Brohi, Karim

    PY - 2013/7/11

    Y1 - 2013/7/11

    N2 - Background: The BIG score (Admission base deficit (B), International normalized ratio (I), andGlasgow Coma Scale (G)) has been shown to predict mortality on admission inpediatric trauma patients. The objective of this study was to assess itsperformance in predicting mortality in an adult trauma population, and to compareit with the existing Trauma and Injury Severity Score (TRISS) and probability ofsurvival (PS09) score.Materials and methods: A retrospective analysis using data collected between 2005 and 2010 from seventrauma centers and registries in Europe and the United States of America wasperformed. We compared the BIG score with TRISS and PS09 scores in a population ofblunt and penetrating trauma patients. We then assessed the discrimination abilityof all scores via receiver operating characteristic (ROC) curves and compared theexpected mortality rate (precision) of all scores with the observed mortalityrate.Results: In total, 12,206 datasets were retrieved to validate the BIG score. The mean ISSwas 15 ± 11, and the mean 30-day mortality rate was 4.8%. With an AUROC of0.892 (95% confidence interval (CI): 0.879 to 0.906), the BIG score performed wellin an adult population. TRISS had an area under ROC (AUROC) of 0.922 (0.913 to0.932) and the PS09 score of 0.825 (0.915 to 0.934). On a penetrating-traumapopulation, the BIG score had an AUROC result of 0.920 (0.898 to 0.942) comparedwith the PS09 score (AUROC of 0.921; 0.902 to 0.939) and TRISS (0.929; 0.912 to0.947).Conclusions: The BIG score is a good predictor of mortality in the adult trauma population. Itperformed well compared with TRISS and the PS09 score, although it hassignificantly less discriminative ability. In a penetrating-trauma population, theBIG score performed better than in a population with blunt trauma. The BIG scorehas the advantage of being available shortly after admission and may be used topredict clinical prognosis or as a research tool to risk stratify trauma patientsinto clinical trials.

    AB - Background: The BIG score (Admission base deficit (B), International normalized ratio (I), andGlasgow Coma Scale (G)) has been shown to predict mortality on admission inpediatric trauma patients. The objective of this study was to assess itsperformance in predicting mortality in an adult trauma population, and to compareit with the existing Trauma and Injury Severity Score (TRISS) and probability ofsurvival (PS09) score.Materials and methods: A retrospective analysis using data collected between 2005 and 2010 from seventrauma centers and registries in Europe and the United States of America wasperformed. We compared the BIG score with TRISS and PS09 scores in a population ofblunt and penetrating trauma patients. We then assessed the discrimination abilityof all scores via receiver operating characteristic (ROC) curves and compared theexpected mortality rate (precision) of all scores with the observed mortalityrate.Results: In total, 12,206 datasets were retrieved to validate the BIG score. The mean ISSwas 15 ± 11, and the mean 30-day mortality rate was 4.8%. With an AUROC of0.892 (95% confidence interval (CI): 0.879 to 0.906), the BIG score performed wellin an adult population. TRISS had an area under ROC (AUROC) of 0.922 (0.913 to0.932) and the PS09 score of 0.825 (0.915 to 0.934). On a penetrating-traumapopulation, the BIG score had an AUROC result of 0.920 (0.898 to 0.942) comparedwith the PS09 score (AUROC of 0.921; 0.902 to 0.939) and TRISS (0.929; 0.912 to0.947).Conclusions: The BIG score is a good predictor of mortality in the adult trauma population. Itperformed well compared with TRISS and the PS09 score, although it hassignificantly less discriminative ability. In a penetrating-trauma population, theBIG score performed better than in a population with blunt trauma. The BIG scorehas the advantage of being available shortly after admission and may be used topredict clinical prognosis or as a research tool to risk stratify trauma patientsinto clinical trials.

    UR - http://www.scopus.com/inward/record.url?scp=84880001708&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=84880001708&partnerID=8YFLogxK

    U2 - 10.1186/cc12813

    DO - 10.1186/cc12813

    M3 - Article

    VL - 17

    JO - Critical Care

    JF - Critical Care

    SN - 1364-8535

    IS - 4

    M1 - R134

    ER -