Reassessing mechanism as a predictor of pediatric injury mortality.
Reassessing mechanism as a predictor of pediatric injury mortality.
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重新评估作为儿科伤害死亡率预测因子的机制。
DOI：
10.1016/j.jss.2015.06.043
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Burd,RandallS
中科院分区：
文献类型：
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作者：
Beck,HaleyE;Mittal,Sushil;Madigan,David;Burd,RandallS
背景使用损伤机制作为损伤结果的预测因子存在实际挑战，因为在许多数据库中该变量可能缺失或不准确。本研究的目的是确定的重要性，损伤的机制，作为一个预测的死亡率受伤的children.MethodsThe记录的儿童（<15岁）持续钝伤从国家创伤数据库。使用损伤机制和损伤编码（使用简化的损伤量表后点值（低维损伤编码）或损伤国际疾病分类第九次修订代码及其双向相互作用（高维损伤编码））开发了预测损伤死亡率的模型。模型的性能与不包括损伤的机制进行了比较，两种编码方案，损伤的机制作为一个变量，在每个模型type.ResultsAmong 62,569记录，死亡率为0.9%的相对重要性进行了评估。当使用低维损伤编码时，纳入损伤机制改善了模型性能，但当使用高维损伤编码时，没有改善。损伤机制贡献了28%的模型方差时，使用低维损伤编码和<1%时，高维损伤codingwasused.ConclusionsAlthough损伤机制可能是一个重要的预测损伤死亡率在儿童遭受钝性创伤，其重要性作为一个预测死亡率取决于用于损伤编码的方法。当使用编码方案更好地表征儿童钝性创伤后持续的损伤时，损伤机制不是损伤后结局的重要预测因素。
BackgroundThe use of mechanism of injury as a predictor of injury outcome presents practical challenges because this variable may be missing or inaccurate in many databases. The purpose of this study was to determine the importance of mechanism of injury as a predictor of mortality among injured children.MethodsThe records of children (<15-y-old) sustaining a blunt injury were obtained from the National Trauma Data Bank. Models predicting injury mortality were developed using mechanism of injury and injury coding using either abbreviated injury scale post-dot values (low-dimensional injury coding) or injury International Classification of Diseases, Ninth Revision codes and their two-way interactions (high-dimensional injury coding). Model performance with and without inclusion of mechanism of injury was compared for both coding schemes, and the relative importance of mechanism of injury as a variable in each model type was evaluated.ResultsAmong 62,569 records, a mortality rate of 0.9% was observed. Inclusion of mechanism of injury improved model performance when using low-dimensional injury coding but was associated with no improvement when using high-dimensional injury coding. Mechanism of injury contributed to 28% of model variance when using low-dimensional injury coding and <1% when high-dimensional injury coding was used.ConclusionsAlthough mechanism of injury may be an important predictor of injury mortality among children sustaining blunt trauma, its importance as a predictor of mortality depends on the approach used for injury coding. Mechanism of injury is not an essential predictor of outcome after injury when coding schemes are used that better characterize injuries sustained after blunt pediatric trauma.