Spanish vs USA cohort comparison of prehospital trauma scores to predict short-term mortality

Diego Moreno-Blanco; Erik Alonso; Ancor Sanz-García; Elisabete Aramendi; Raúl López-Izquierdo; Rubén Pérez García; Carlos Del Pozo Vegas; Francisco Martín-Rodríguez

doi:10.1016/j.clinme.2024.100208

Spanish vs USA cohort comparison of prehospital trauma scores to predict short-term mortality

Clin Med (Lond). 2024 Apr 19:100208. doi: 10.1016/j.clinme.2024.100208. Online ahead of print.

Authors

Diego Moreno-Blanco¹, Erik Alonso², Ancor Sanz-García³, Elisabete Aramendi⁴, Raúl López-Izquierdo⁵, Rubén Pérez García⁶, Carlos Del Pozo Vegas⁷, Francisco Martín-Rodríguez⁸

Affiliations

¹ Department of Communications Engineering, University of the Basque Country (UPV/EHU), Bilbao, Spain; Biomedical Engineering and Telemedicine Centre, ETSI de Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain.
² Department of Applied Mathematics, University of the Basque Country (UPV/EHU), Bilbao, Spain.
³ Faculty of Health Sciences, University of Castilla - La Mancha (UCLM), Talavera, Spain. Electronic address: ancor.sanz@gmail.com.
⁴ Department of Communications Engineering, University of the Basque Country (UPV/EHU), Bilbao, Spain.
⁵ Faculty of Medicine, University of Valladolid, Valladolid, Spain; CIBER of Respiratory Diseases, Instituto de Salud Carlos III, Madrid, Spain; Emergency Department. Hospital Universitario Rio Hortega. Valladolid, Spain.
⁶ Emergency Department. Hospital Universitario Rio Hortega. Valladolid, Spain.
⁷ Faculty of Medicine, University of Valladolid, Valladolid, Spain; Emergency Department. Hospital Clínico Universitario. Valladolid, Spain.
⁸ Faculty of Medicine, University of Valladolid, Valladolid, Spain; Advanced Life Support, Emergency Medical Services (SACYL), Valladolid, Spain.

PMID: 38643832
DOI: 10.1016/j.clinme.2024.100208

Abstract

Background: This study aimed to evaluate three prehospital early warning scores (EWSs): RTS, MGAP and MREMS, to predict short-term mortality in acute life-threatening trauma and injury/illness by comparing United States (US) and Spanish cohorts.

Methods: A total of 8854 patients, 8598/256 survivors/nonsurvivors, comprised the unified cohort. Datasets were randomly divided into training and test sets. Training sets were used to analyze the discriminative power of the scores in terms of the area under the curve (AUC), and the score performance was assessed in the test set in terms of sensitivity (SE), specificity (SP), accuracy (ACC) and balanced accuracy (BAC).

Results: The three scores showed great discriminative power with AUCs>0.90, and no significant differences between cohorts were found. In the test set, RTS/MREMS/MGAP showed SE/SP/ACC/BAC values of 86.0/89.9/89.6/87.1%, 91.0/86.9/87.5/88.5%, and 87.7/82.9/83.4/85.2%, respectively.

Conclusions: All EWSs showed excellent ability to predict the risk of short-term mortality, independent of the country.

Keywords: Early warning scores; Prehospital; Short-term mortality; Trauma.