The prediction of the survival in patients with severe trauma during prehospital care: Analyses based on NTDB database.

Purpose: Traumas cause great casualties, accompanied by heavy economic burdens every year. The study aimed to use ML (machine learning) survival algorithms for predicting the 8-and 24-hour survival of severe traumas. Methods: A retrospective study using data from National Trauma Data Bank (NTDB) was...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 50; no. 4; pp. 1599 - 1610
Autores principales: Peng, Chi, Peng, Liwei, Yang, Fan, Yu, Hang, Chen, Qi, Guo, Yibin, Xu, Shuogui, Jin, Zhichao
Formato: research tables/charts Journal Article
Publicado: Springer Nature Aug2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2024
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-024-02484-0
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        atl: The prediction of the survival in patients with severe trauma during prehospital care: Analyses based on NTDB database.
      aug:
        au:
          Peng, Chi
          Peng, Liwei
          Yang, Fan
          Yu, Hang
          Chen, Qi
          Guo, Yibin
          Xu, Shuogui
          Jin, Zhichao
        affil: https://ror.org/05w21nn13 Department of Health Statistics, Naval Military Medical University, No. 800 Xiangyin Road, 200433, Shanghai, China
      sug:
        subj:
          Trauma Prognosis
          Prehospital Care
          Machine Learning
          Algorithms
          Survival Analysis
          Human
          Retrospective Design
          Random Forest
          Cox Proportional Hazards Model
          Prediction Models
          Glasgow Coma Scale
          Funding Source
          Scales
      ab: Purpose: Traumas cause great casualties, accompanied by heavy economic burdens every year. The study aimed to use ML (machine learning) survival algorithms for predicting the 8-and 24-hour survival of severe traumas. Methods: A retrospective study using data from National Trauma Data Bank (NTDB) was conducted. Four ML survival algorithms including survival tree (ST), random forest for survival (RFS) and gradient boosting machine (GBM), together with a Cox proportional hazard model (Cox), were utilized to develop the survival prediction models. Following this, model performance was determined by the comparison of the C-index, integrated Brier score (IBS) and calibration curves in the test datasets. Results: A total of 191,240 individuals diagnosed with severe trauma between 2015 and 2018 were identified. Glasgow Coma Scale (GCS), trauma type, age, SaO2, respiratory rate (RR), systolic blood pressure (SBP), EMS transport time, EMS on-scene time, pulse, and EMS response time were identified as the main predictors. For predicting the 8-hour survival with the complete cases, the C-indexes in the test sets were 0.853 (0.845, 0.861), 0.823 (0.812, 0.834), 0.871 (0.862, 0.879) and 0.857 (0.849, 0.865) for Cox, ST, RFS and GBM, respectively. Similar results were observed in the 24-hour survival prediction models. The prediction error curves based on IBS also showed a similar pattern for these models. Additionally, a free web-based calculator was developed for potential clinical use. Conclusion: The RFS survival algorithms provide non-parametric alternatives to other regression models to be of clinical use for estimating the survival probability of severe trauma patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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