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Evaluation of the Geriatric Trauma Outcome Score (GTOS) as a Prognostic Tool in Intensive Care Unit Trauma Patients

Authors :
Ching-Ya Huang
Shao-Chun Wu
Hang-Tsung Liu
Wei-Ti Su
Shiun-Yuan Hsu
Chi Li
Ching-Hua Hsieh
Source :
Diagnostics, Vol 14, Iss 19, p 2146 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Background: Existing prognostic scoring systems for intensive care unit (ICU) trauma patients require extensive data collection. The Geriatric Trauma Outcome Score (GTOS), which is based on age, injury severity, and transfusion need, has been validated for predicting mortality in elderly patients with trauma; however, its utility in the general ICU trauma population remains unexplored. Methods: This retrospective study included 2952 adult ICU trauma patients admitted between 2016 and 2021. The GTOS was calculated as follows: age + (Injury Severity Score × 2.5) + 22 (if transfused within 24 h). The area under the receiver operating characteristic curve (AUROC) was used to assess GTOS’s ability to predict mortality. The optimal GTOS cutoff was determined using Youden’s index. Mortality rates were compared between the high and low GTOS groups, including a propensity score-matched analysis adjusted for baseline characteristics. Results: This study included 2952 ICU trauma patients, with an overall mortality rate of 11.0% (n = 325). GTOS demonstrated good predictive accuracy for mortality (AUROC 0.80). The optimal cutoff was 121.8 (sensitivity, 0.791; specificity, 0.685). Despite adjustments, patients with GTOS ≥ 121.8 had significantly higher mortality (17.4% vs. 6.2%, p < 0.001) and longer hospital stays (20.3 vs. 15.3 days, p < 0.001) compared to GTOS < 121.8. Conclusions: GTOS showed a reasonable ability to predict mortality in ICU trauma patients across all ages, although not as accurately as more complex ICU-specific models. With its simplicity, the GTOS may serve as a rapid screening tool for risk stratification in acute ICU trauma settings when combined with other data.

Details

Language :
English
ISSN :
20754418
Volume :
14
Issue :
19
Database :
Directory of Open Access Journals
Journal :
Diagnostics
Publication Type :
Academic Journal
Accession number :
edsdoj.2d0ca657a3ac479395a85e78abbc58ab
Document Type :
article
Full Text :
https://doi.org/10.3390/diagnostics14192146