Please use this identifier to cite or link to this item: https://doi.org/10.1186/s13049-018-0497-y
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dc.titleOne-year and three-year mortality prediction in adult major blunt trauma survivors: A National Retrospective Cohort Analysis
dc.contributor.authorWong T.H.
dc.contributor.authorNadkarni N.V.
dc.contributor.authorNguyen H.V.
dc.contributor.authorLim G.H.
dc.contributor.authorMatchar D.B.
dc.contributor.authorSeow D.C.C.
dc.contributor.authorKing N.K.K.
dc.contributor.authorOng M.E.H.
dc.date.accessioned2020-09-07T05:06:40Z
dc.date.available2020-09-07T05:06:40Z
dc.date.issued2018
dc.identifier.citationWong T.H., Nadkarni N.V., Nguyen H.V., Lim G.H., Matchar D.B., Seow D.C.C., King N.K.K., Ong M.E.H. (2018). One-year and three-year mortality prediction in adult major blunt trauma survivors: A National Retrospective Cohort Analysis. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 26 (1) : 28. ScholarBank@NUS Repository. https://doi.org/10.1186/s13049-018-0497-y
dc.identifier.issn17577241
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/174542
dc.description.abstractBackground: Survivors of trauma are at increased risk of dying after discharge. Studies have found that age, head injury, injury severity, falls and co-morbidities predict long-term mortality. The objective of our study was to build a nomogram predictor of 1-year and 3-year mortality for major blunt trauma adult survivors of the index hospitalization. Methods: Using data from the Singapore National Trauma Registry, 2011-2013, we analyzed adults aged 18 and over, admitted after blunt injury, with an injury severity score (ISS) of 12 or more, who survived the index hospitalization, linked to death registry data. The study population was randomly divided 60/40 into separate construction and validation datasets, with the model built in the construction dataset, then tested in the validation dataset. Multivariable logistic regression was used to analyze 1-year and 3-year mortality. Results: Of the 3414 blunt trauma survivors, 247 (7.2%) died within 1 year, and 551 (16.1%) died within 3 years of injury. Age (OR 1.06, 95% CI 1.05-1.07, p < 0.001), male gender (OR 1.53, 95% CI 1.12-2.10, p < 0.01), low fall from 0.5 m or less (OR 3.48, 95% CI 2.06-5.87, p < 0.001), Charlson comorbidity index of 2 or more (OR 2.26, 95% CI 1.38-3.70, p < 0.01), diabetes (OR 1.31, 95% CI 1.68-2.52, p = 0.04), cancer (OR 1.76, 95% CI 0.94-3.32, p = 0.08), head and neck AIS 3 or more (OR 1.79, 95% CI 1.13-2.84, p = 0.01), length of hospitalization of 30 days or more (OR 1.99, 95% CI 1.02-3.86, p = 0.04) were predictors of 1-year mortality. This model had a c-statistic of 0.85. Similar factors were found significant for the model predictor of 3-year mortality, which had a c-statistic of 0.83. Both models were validated on the second dataset, with an overall accuracy of 0.94 and 0.84 for 1-year and 3-year mortality respectively. Conclusions: Adult survivors of major blunt trauma can be risk-stratified at discharge for long-term support. © 2018 The Author(s).
dc.publisherBioMed Central Ltd.
dc.sourceUnpaywall 20200831
dc.subjectadult
dc.subjectaged
dc.subjectblunt trauma
dc.subjectcomorbidity
dc.subjectepidemiology
dc.subjectfemale
dc.subjecthospital discharge
dc.subjecthuman
dc.subjectinjury scale
dc.subjectmale
dc.subjectmiddle aged
dc.subjectmortality
dc.subjectregister
dc.subjectretrospective study
dc.subjectSingapore
dc.subjectstatistical model
dc.subjectsurvivor
dc.subjecttrends
dc.subjectvery elderly
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectComorbidity
dc.subjectFemale
dc.subjectHumans
dc.subjectInjury Severity Score
dc.subjectLogistic Models
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMortality
dc.subjectPatient Discharge
dc.subjectRegistries
dc.subjectRetrospective Studies
dc.subjectSingapore
dc.subjectSurvivors
dc.subjectWounds, Nonpenetrating
dc.typeArticle
dc.contributor.departmentDEAN'S OFFICE (MEDICINE)
dc.contributor.departmentDEPT OF MEDICINE
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.doi10.1186/s13049-018-0497-y
dc.description.sourcetitleScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
dc.description.volume26
dc.description.issue1
dc.description.page28
dc.published.statePublished
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