Validation of a Visual-Based Analytics Tool for Outcome Prediction in Polytrauma Patients (WATSON Trauma Pathway Explorer) and Comparison with the Predictive Values of TRISS
Abstract
:1. Introduction
- (i)
- to validate the WATSON Explorer in a different patient population;
- (ii)
- to expand the predictive capacity from mortality to clinical complications, such as SIRS and sepsis;
- (iii)
- to compare aspects of prediction with the TRISS methodology.
2. Methods
2.1. Inclusion/Exclusion Criteria
2.2. Definitions
2.3. Clinical Course
2.4. Statistics
2.5. Development of the Model and Validation
3. Results
3.1. General Characteristics
3.2. Model Performance
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Predictors in WATSON | Predictors in TRISS | Measurement |
---|---|---|
Age | Age | Admission report, numerical data |
Temperature | — | Admission report, numerical data |
ISS | ISS | Admission report, ordinal data |
AIS filter for head injury | — | Admission report, binary data |
— | GCS | Rescue service log, ordinal data |
— | Systolic blood pressure | Rescue service log, numerical data |
— | Respiratory rate | Rescue service log, numerical data |
— | Type of trauma | Admission report, binary data |
Validation Group | Development Group | ||||
---|---|---|---|---|---|
Patient Sample n = 107 | Survivors n = 96 | Non-Survivors n = 11 | p-Value | Patient Sample n = 3647 | |
Age (mean, SD) | 48.3 ± 19.7 | 47.1 ± 19.0 | 58.7 ± 24.0 | 0.063 | 45.8 ± 20.2 |
Male | 69.2% (n = 74) | 69.8 % (n = 67) | 63.6% (n = 7) | — | 73.5 % (n = 2680) |
Blunt trauma | 99.1% (n = 106) | 100% (n = 96) | 90.9% (n = 10) | — | 91.3% (n = 3329) |
ATLS shock class (median, IQR) | 1 (1–3) | 1 (1–3) | 1 (1–3.5) | 0.149 | 1 (1–2) |
ISS (median, IQR) | 30 (23–36) | 29 (22–34.5) | 42 (31–66) | 0.009 | 25 (17–34) |
Temperature at admission (mean, SD) | 35.9 ± 1.3 | 36.0 ± 1.2 | 34.9 ± 1.6 | 0.007 | 35.5 ± 1.7 |
Head injury | 70.1% (n = 75) | 67.7% (n = 65) | 90.9% (n = 10) | — | 76.2% (n = 2780) |
SIRS (within 21 days) | 76.6% (n= 82) | 75.0% (n = 72) | 90.9% (n = 10) | — | 83.5% (n = 3044) |
Sepsis (within 21 days) | 12.1% (n = 13) | 13.5% (n = 13) | 0% (n = 0) | — | 15.0% (n = 546) |
Early Death (within 72 h) | 10.3% (n = 11) | — | — | — | 19.4% (n = 709) |
GCS at patient contact (median, IQR) | 13 (8.5–15) | 14 (9–15) | 3 (3–9.5) | <0.001 | — |
SBP at patient contact (mean, SD) | 119 ± 37 | 122 ± 32 | 98 ± 66 | 0.039 | — |
RR at patient contact (mean, SD) | 17.3 ± 6.7 | 17.8 ± 6.5 | 12.9 ± 7.4 | 0.022 | — |
RTS at patient contact (median, IQR) | 6.90 (5.97–7.84) | 7.11 (6.38–7.84) | 4.09 (3.73–5.71) | <0.001 | — |
AUC | H-L Statistics | Brier SCORE | |
---|---|---|---|
SIRS by WATSON | 0.77 (95% CI 0.68–0.85) | X2 = 5.24, p = 0.73 | 0.15 |
Sepsis by WATSON | 0.71 (95% CI 0.58–0.83) | X2 = 12.14, p = 0.14 | 0.12 |
Early Death by WATSON | 0.90 (95% CI 0.79–0.99) | X2 = 8.19, p = 0.42 | 0.06 |
Early Death by TRISS | 0.88 (95% CI 0.77–0.97) | X2 = 31.93, p < 0.05 | 0.11 |
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Niggli, C.; Pape, H.-C.; Niggli, P.; Mica, L. Validation of a Visual-Based Analytics Tool for Outcome Prediction in Polytrauma Patients (WATSON Trauma Pathway Explorer) and Comparison with the Predictive Values of TRISS. J. Clin. Med. 2021, 10, 2115. https://doi.org/10.3390/jcm10102115
Niggli C, Pape H-C, Niggli P, Mica L. Validation of a Visual-Based Analytics Tool for Outcome Prediction in Polytrauma Patients (WATSON Trauma Pathway Explorer) and Comparison with the Predictive Values of TRISS. Journal of Clinical Medicine. 2021; 10(10):2115. https://doi.org/10.3390/jcm10102115
Chicago/Turabian StyleNiggli, Cédric, Hans-Christoph Pape, Philipp Niggli, and Ladislav Mica. 2021. "Validation of a Visual-Based Analytics Tool for Outcome Prediction in Polytrauma Patients (WATSON Trauma Pathway Explorer) and Comparison with the Predictive Values of TRISS" Journal of Clinical Medicine 10, no. 10: 2115. https://doi.org/10.3390/jcm10102115