PDF(Pubmed)
Abstract：
UNASSIGNED: Mortality is the primary outcome measure in severely injured trauma victims. However, quality indicators for survivors are rare. We aimed to develop and validate an outcome measure based on length of stay on the intensive care unit (ICU).
UNASSIGNED: The TraumaRegister DGU of the German Trauma Society (DGU) was used to identify 108,178 surviving patients with serious injuries who required treatment on ICU (2014-2018). In a first step, need for prolonged ICU stay, defined as 8 or more days, was predicted. In a second step, length of stay was estimated in patients with a prolonged stay. Data from the same trauma registry (2019-2022, n = 72,062) were used to validate the models derived with logistic and linear regression analysis.
UNASSIGNED: The mean age was 50 years, 70% were males, and the average Injury Severity Score was 16.2 points. Average/median length of stay on ICU was 6.3/2 days, where 78% were discharged from ICU within the first 7 days. Prediction of need for a prolonged ICU stay revealed 15 predictors among which injury severity (worst Abbreviated Injury Scale severity level), need for intubation, and pre-trauma condition were the most important ones. The area under the receiver operating characteristic curve was 0.903 (95% confidence interval 0.900-0.905). Length of stay prediction in those with a prolonged ICU stay identified the need for ventilation and the number of injuries as the most important factors. Pearson\'s correlation of observed and predicted length of stay was 0.613. Validation results were satisfactory for both estimates.
UNASSIGNED: Length of stay on ICU is a suitable outcome measure in surviving patients after severe trauma if adjusted for severity. The risk of needing prolonged ICU care could be calculated in all patients, and observed vs. predicted rates could be used in quality assessment similar to mortality prediction. Length of stay prediction in those who require a prolonged stay is feasible and allows for further benchmarking.
UNASSIGNED: The TraumaRegister DGU of the German Trauma Society (DGU) was used to identify 108,178 surviving patients with serious injuries who required treatment on ICU (2014-2018). In a first step, need for prolonged ICU stay, defined as 8 or more days, was predicted. In a second step, length of stay was estimated in patients with a prolonged stay. Data from the same trauma registry (2019-2022, n = 72,062) were used to validate the models derived with logistic and linear regression analysis.
UNASSIGNED: The mean age was 50 years, 70% were males, and the average Injury Severity Score was 16.2 points. Average/median length of stay on ICU was 6.3/2 days, where 78% were discharged from ICU within the first 7 days. Prediction of need for a prolonged ICU stay revealed 15 predictors among which injury severity (worst Abbreviated Injury Scale severity level), need for intubation, and pre-trauma condition were the most important ones. The area under the receiver operating characteristic curve was 0.903 (95% confidence interval 0.900-0.905). Length of stay prediction in those with a prolonged ICU stay identified the need for ventilation and the number of injuries as the most important factors. Pearson\'s correlation of observed and predicted length of stay was 0.613. Validation results were satisfactory for both estimates.
UNASSIGNED: Length of stay on ICU is a suitable outcome measure in surviving patients after severe trauma if adjusted for severity. The risk of needing prolonged ICU care could be calculated in all patients, and observed vs. predicted rates could be used in quality assessment similar to mortality prediction. Length of stay prediction in those who require a prolonged stay is feasible and allows for further benchmarking.
摘要：
■死亡率是严重受伤创伤受害者的主要结局指标。然而,幸存者的质量指标很少见。我们旨在根据重症监护病房（ICU）的住院时间来开发和验证结局指标。
■德国创伤协会（DGU）的TraumaRegisterDGU用于识别108,178名存活的严重受伤患者需要在ICU接受治疗（2014-2018）。第一步,需要长时间住在ICU，定义为8天或更长时间，是预测的。第二步,住院时间估计为住院时间延长的患者.来自同一创伤登记处（2019-2022年，n=72,062）的数据用于验证通过逻辑和线性回归分析得出的模型。
■平均年龄为50岁，70%是男性,平均损伤严重程度评分为16.2分。在ICU住院的平均/中位数为6.3/2天，其中78%在前7天内从ICU出院。对ICU住院时间延长的预测显示了15种预测因素，其中包括损伤严重程度（最严重的缩写损伤量表严重程度）。需要插管，创伤前的状况是最重要的。受试者工作特征曲线下面积为0.903(95%置信区间0.900-0.905)。ICU住院时间延长的患者的住院时间预测将通气需求和受伤次数确定为最重要的因素。观察到的和预测的住院时间的Pearson相关性为0.613。两种估计的验证结果均令人满意。
■对于严重创伤后存活患者，ICU住院时间是一个合适的预后指标。可以计算所有患者需要长期ICU护理的风险，并观察到与预测率可用于类似于死亡率预测的质量评估。那些需要长期逗留的人的逗留时间预测是可行的，并允许进一步的基准测试。
■德国创伤协会（DGU）的TraumaRegisterDGU用于识别108,178名存活的严重受伤患者需要在ICU接受治疗（2014-2018）。第一步,需要长时间住在ICU，定义为8天或更长时间，是预测的。第二步,住院时间估计为住院时间延长的患者.来自同一创伤登记处（2019-2022年，n=72,062）的数据用于验证通过逻辑和线性回归分析得出的模型。
■平均年龄为50岁，70%是男性,平均损伤严重程度评分为16.2分。在ICU住院的平均/中位数为6.3/2天，其中78%在前7天内从ICU出院。对ICU住院时间延长的预测显示了15种预测因素，其中包括损伤严重程度（最严重的缩写损伤量表严重程度）。需要插管，创伤前的状况是最重要的。受试者工作特征曲线下面积为0.903(95%置信区间0.900-0.905)。ICU住院时间延长的患者的住院时间预测将通气需求和受伤次数确定为最重要的因素。观察到的和预测的住院时间的Pearson相关性为0.613。两种估计的验证结果均令人满意。
■对于严重创伤后存活患者，ICU住院时间是一个合适的预后指标。可以计算所有患者需要长期ICU护理的风险，并观察到与预测率可用于类似于死亡率预测的质量评估。那些需要长期逗留的人的逗留时间预测是可行的，并允许进一步的基准测试。
