基于ROC曲线的几种创伤严重程度评估工具对老年创伤患者院内死亡预测效果的对比研究  

Comparative study on predictive effect of several trauma severity assessment tools based on ROC curve on hospital death in elderly trauma patients

作　　者：王琦 朱江静 覃机勇 WANG Qi;ZHU Jiangjing;QIN Jiyong(Department of Emergency Medicine,Lliuzhou Traditional Chinese Medical Hosital,Liuzhou Guangxi 545000,China;Department of Emergency Medicine,Liuzhou People′s Hospital,Liuzhou Guangxi 545006,China)

机构地区：[1]柳州市中医医院急诊医学科,广西柳州545000 [2]柳州市人民医院急诊医学科,广西柳州545006

出　　处：《新疆医科大学学报》2024年第4期564-569,共6页Journal of Xinjiang Medical University

基　　金：广西壮族自治区卫生健康委员会自筹经费课题(Z20200075)。

摘　　要：目的比较新损伤严重程度评分(NISS)、指数型损伤严重程度评分(EISS)、创伤和损伤严重程度评分(TRISS)及老年创伤结局评分(GTOS)用于预测老年创伤患者院内死亡风险的效果。方法回顾性追溯选定时间跨度(2019年1月至2022年12月)内所有经急诊入院的老年创伤患者(共197例)的临床资料,计算并统计上述4种创伤严重程度评估工具的结果并绘制受试者工作特征(ROC)曲线,分析比较各评估工具的ROC曲线下面积(AUC)、约登指数以及敏感度、特异度,并以传统的损伤严重程度评分(ISS)的结果作为对照。结果4种改进型评估工具的预测效果均优于传统评估工具(ISS评分)。其中,TRISS评分的AUC、约登指数、敏感度和特异度均最高;NISS评分的AUC和约登指数均最低;GTOS评分的AUC和敏感度与EISS评分较为接近,但约登指数和特异度均显著高于EISS评分。结论TRISS评分在急诊老年创伤患者死亡风险预测评估方面的综合应用效果最佳,GTOS评分预测效果不及TRISS,但评估计算过程更简单,其改进和优化值得进一步探索。Objective To compare the prediction utilities of New Injury Severity Score(NISS),Exponential Injury Severity Score(EISS),Trauma and Injury Severity Score(TRISS),and Geriatric Trauma Outcome Score(GTOS)for in-hospital mortality of geriatric trauma patients.Methods The clinical data of all 197 elderly trauma patients admitted to the hospital during a selected time span(Jan 2019 to Dec 2022)were retrospectively collected as the samples.The results of the aforementioned4 trauma severity assessment tools were calculated and statistically analyzed,and receiveroperator characteristic(ROC)curveswere plotted.Furthermore,area under ROC curve(AUC),Youden index,sensitivity,and specificity of each assessment tool were analyzed and compared,and the corresponding results of traditional Injury Severity Score(ISS)were used as a control.Results The predictive performances of the 4 improved evaluation tools were better than that of traditional evaluation tool(ISS).Among them,TRISS had the highest AUC,Jordan index,sensitivity,and specificity,and AUC and Youden index of NISS were both the lowest.AUC and sensitivity of GTOS were relatively close to EISS,but itsYouden index and specificity were significantly higher than the latter.Conclusion TRISS scorehas the best comprehensive application effect in predicting and evaluatingthe death risk of elderly emergency geriatric trauma patients,while GTOS score has a lower predictive effect than TRISS,but the evaluation calculation process is simpler,and its improvement and optimization are worthy of further exploration.

关 键 词：受试者工作特征曲线(ROC曲线) 老年创伤 新损伤严重程度评分(NISS) 指数型损伤严重程度评分(EISS) 创伤严重程度评分(TRISS) 老年创伤结局评分(GTOS) 

分 类 号：R64[医药卫生—外科学]