Journal of Emergencies, Trauma, and Shock
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Year : 2019  |  Volume : 12  |  Issue : 3  |  Page : 192-197

A novel risk score to predict post-trauma mortality in nonagenarians

1 Department of Surgery, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, New York, USA
2 School of Medicine, St. George's University, Grenada, West Indies, Grenada
3 George Washington University, Washington, DC, USA
4 Department of Surgery, NYU Brooklyn Hospital, Brooklyn, New York, USA

Correspondence Address:
Mr. Vishaka K Chetram
School of Medicine, St. George's University, Grenada
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JETS.JETS_145_18

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Background: Nonagenarians represent a rapidly growing age group who often have functional limitations and multiple comorbidities, predisposing them to trauma. Aims: The purpose of this study was to identify patient characteristics, hospital complications, and comorbidities that predict in-hospital mortality in the nonagenarian population following trauma. We also sought to create a scoring system using these variables. Settings and Design: This study was a retrospective chart review. Methods: We reviewed the medical records of 548 nonagenarian trauma patients admitted to two Level I trauma centers from 2006 to 2015. Statistical analysis was performed using logistic regression and a machine learning model, which calculated significant variables and computed a scoring system. Results: The in-hospital mortality rate was 7.1% (n = 39). Significant predictors of mortality were cardiac comorbidity, neuro-concussion, New Injury Severity Score (ISS) 16+, striking an object, ISS 25–75, and pulmonary and cardiac complications. Significant variables were assigned a numeric value. A score of 5+ carried a 41.1% mortality risk, 79% sensitivity, and 91% specificity. A score of 10+ had an associated 81.8% mortality risk with 31% specificity and 99% sensitivity. Conclusions: Our findings identified reliable predictors of mortality in nonagenarian population posttrauma. The scoring system performs with good specificity and sensitivity and incrementally correlates with mortality risk.

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