Faculty Collaboration Database

Is the Trauma Mortality Prediction Model (TMPM-ICD-9) a valid predictor of mortality in pediatric trauma patients? J Pediatr Surg 2014 Jan;49(1):189-92; discussions 192

Date

01/21/2014

Pubmed ID

24439607

DOI

10.1016/j.jpedsurg.2013.09.055

Scopus ID

2-s2.0-84892585772 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

BACKGROUND/PURPOSE: Researchers are constantly challenged to identify optimal mortality risk adjustment methodologies that perform accurately in pediatric trauma patients. This study evaluated the new Trauma Mortality Prediction Model (TMPM-ICD-9) in pediatric trauma patients.

METHODS: Data were analyzed on 107,104 pediatric trauma patients included in the NTDB® in 2010 who had both a valid ISS and probability of death using TMPM-ICD-9. Discrimination was compared using the area under the receiver operator characteristic curve (AUC) and by age, blunt vs penetrating, intent, Glasgow Coma Scale (GCS), and number of injuries.

RESULTS: The AUC for TMPM-ICD-9 demonstrated excellent discrimination in predicting mortality versus ISS overall, 11 to 17years of age (0.96 vs 0.93), by injury type, intent, and in the lowest GCS scores. The TMPM-ICD-9 showed superior discrimination over ISS in patients with more than two injuries.

CONCLUSIONS: The TMPM demonstrated superior discrimination compared to ISS. The TMPM shows promise of a much needed and simple to use risk adjustment tool with application to both adult and pediatric patients. Researchers should continue to validate this tool in robust pediatric data sets.

Author List

Cassidy LD, Cook A, Ertl A, Gourlay D, Osler T

Authors

Laura Cassidy PhD Associate Dean, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
David M. Gourlay MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Age Distribution
Area Under Curve
Child
Child, Preschool
Cross-Sectional Studies
Databases, Factual
Female
Glasgow Coma Scale
Humans
Infant
International Classification of Diseases
Male
Models, Theoretical
Multiple Trauma
Prognosis
ROC Curve
Registries
Retrospective Studies
Risk Assessment
Sex Distribution
Trauma Severity Indices
Wounds and Injuries
Wounds, Nonpenetrating
Wounds, Penetrating